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North Carolina rates for HCPCS 25628

Open Tx Carpal Scaphoid Navicular Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.48 / $5,872.81 / $10,124.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,221.47 / $3,221.47 / $4,603.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $6,025.59
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.48 / $938.63 / $1,408.19
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$122.10 / $161.97 / $223.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,015.00 / $15,545.00 / $22,780.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,718.08 / $19,913.50 / $26,542.00
Wellcare
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$166.33 / $1,134.79 / $1,887.52