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Maryland rates for HCPCS 25628

Open Tx Carpal Scaphoid Navicular Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $3,093.24 / $7,537.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $518.54 / $3,314.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.67 / $990.29 / $1,296.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,003.00 / $1,003.00 / $2,156.00