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Nebraska rates for HCPCS 25622

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.99 / $7,119.04 / $20,928.72
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$200.99 / $200.99 / $217.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.53 / $280.93 / $720.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.21 / $700.21 / $700.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,350.61 / $4,406.97 / $8,524.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.08 / $464.11 / $632.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.40 / $193.40 / $193.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.56 / $674.26 / $932.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.99 / $479.46 / $661.80
Medica
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$956.89 / $956.89 / $956.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.08 / $616.07 / $2,186.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.73 / $633.74 / $891.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.00 / $657.20 / $891.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.08 / $663.42 / $797.10