go back

Virginia 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
$1,244.00 / $4,771.00 / $8,920.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,823.00 / $12,004.00 / $15,528.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $823.94
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$81.69 / $81.69 / $81.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.31 / $892.56 / $1,053.53
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.76 / $925.97 / $1,355.41
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$122.10 / $168.00 / $261.23
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$696.21 / $906.50 / $3,381.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,408.00 / $13,296.00 / $26,537.00