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Michigan 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
$1,000.00 / $4,073.80 / $15,488.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $4,073.80 / $8,912.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $9,120.11 / $16,595.87