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Michigan rates for HCPCS 25622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $331.13 / $645.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $223.87 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $380.19 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $331.13 / $562.34
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $870.96 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $380.19 / $588.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $323.59 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $794.33 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $331.13 / $436.52