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Louisiana rates for HCPCS 25628

Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $2,187.76 / $5,623.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $9,772.37 / $14,125.38
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $6,456.54 / $13,489.63