go back

Texas rates for HCPCS 25455

Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.65 / $3,224.00 / $11,453.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.90 / $738.17 / $1,258.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,512.96 / $4,434.67 / $9,126.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.31 / $859.85 / $1,171.70
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $672.50 / $682.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.48 / $835.48 / $835.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.58 / $938.93 / $1,429.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,758.56 / $11,500.00 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,633.52 / $5,819.43 / $6,350.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.76 / $914.04 / $1,412.76
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$908.13 / $1,089.75 / $1,351.29
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.60 / $997.60 / $997.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.76 / $917.36 / $1,515.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.11 / $971.34 / $1,494.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,211.00 / $6,566.00 / $13,134.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.00 / $757.88 / $1,186.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.04 / $703.11 / $978.10