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Maine rates for HCPCS 25605

Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.11 / $646.19 / $2,418.98
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$745.69 / $1,273.88 / $1,698.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.55 / $605.29 / $858.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.47 / $687.85 / $992.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.04 / $807.06 / $1,137.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.63 / $786.71 / $1,235.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.03 / $685.86 / $2,698.75
Martin's Point
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$660.18 / $1,009.31 / $1,698.51
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.13 / $657.26 / $983.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.28 / $707.75 / $1,116.43