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Texas 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
$977.24 / $3,467.37 / $12,022.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $9,332.54 / $18,197.01
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $6,309.57 / $10,232.93
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $645.65 / $660.69
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,952.62 / $45,708.82 / $45,708.82
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $4,168.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $891.25 / $1,548.82
Providence
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$123.03 / $123.03 / $123.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $8,317.64 / $17,378.01