go back

Wisconsin rates for HCPCS 25624

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.56 / $946.78 / $3,119.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.91 / $491.10 / $2,009.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,183.00 / $3,483.00 / $5,962.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.99 / $1,023.61 / $2,584.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,942.50 / $1,942.50 / $1,942.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,339.97 / $1,565.86 / $2,402.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.12 / $1,341.81 / $2,215.82
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.13 / $586.42 / $1,051.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.56 / $689.70 / $3,034.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.53 / $1,063.71 / $3,745.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.59 / $311.01 / $1,021.97
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.13 / $574.59 / $1,051.98
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,006.20 / $1,226.02 / $1,757.91
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,722.47 / $1,722.47 / $2,156.60
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$918.99 / $2,134.04 / $3,745.36
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,453.26 / $1,453.26 / $1,608.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.07 / $2,909.84 / $3,226.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,367.00 / $3,088.30 / $4,295.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.80 / $945.44 / $2,108.69