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Oklahoma rates for HCPCS 25628

Open Tx Carpal Scaphoid Navicular Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,010.22 / $4,500.00 / $12,600.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,873.50 / $12,508.22 / $19,762.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,659.86 / $5,659.86 / $5,659.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.68 / $1,074.88 / $14,063.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$186.87 / $1,887.52 / $1,887.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,851.00 / $7,074.00 / $14,139.00