go back

Wisconsin rates for HCPCS 25675

Closed Tx Distal Radioulnar Dislocation W/Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$307.13 / $342.04 / $1,301.77
Quartz
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$1,378.64 / $1,378.64 / $1,378.64