go back

Louisiana rates for HCPCS 25628

Open Tx Carpal Scaphoid Navicular Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.00 / $1,850.00 / $4,878.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,685.25 / $9,682.37 / $13,982.44
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $651.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,200.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $5,780.00 / $13,506.00