go back

Washington 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
$1,360.28 / $5,128.00 / $20,680.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.65 / $940.96 / $2,053.85
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,961.46 / $9,172.83 / $20,286.13
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.81 / $1,679.31 / $6,482.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$714.97 / $870.49 / $3,740.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.54 / $1,326.30 / $2,250.69
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$692.54 / $1,431.10 / $3,280.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.54 / $1,397.45 / $2,824.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.68 / $399.90 / $1,502.30
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,009.21 / $1,395.61 / $1,492.09
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.25 / $987.54 / $2,961.46
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.96 / $1,619.03 / $2,020.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,006.61 / $9,172.83 / $17,546.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.16 / $1,448.62 / $1,928.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,225.00 / $4,785.00 / $16,315.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.68 / $1,213.84 / $2,130.86
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.04 / $620.04 / $807.24