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Indiana rates for HCPCS 25622

Closed treatment of carpal scaphoid (navicular) fracture; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.32 / $293.86 / $4,846.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$203.49 / $220.40 / $369.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.27 / $292.20 / $396.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.16 / $205.16 / $205.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$856.00 / $4,320.00 / $8,230.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.07 / $263.29 / $363.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.64 / $376.39 / $564.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.52 / $349.82 / $524.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.79 / $172.79 / $204.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.12 / $338.31 / $581.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.46 / $324.49 / $562.52