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Michigan rates for HCPCS 25624

Closed treatment of carpal scaphoid (navicular) fracture; with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,884.03 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $478.63 / $812.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,047.13 / $1,047.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $831.76 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $524.81 / $912.01
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $2,884.03 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $549.54 / $794.33
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $512.86 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $2,137.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $524.81 / $691.83