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Pennsylvania rates for HCPCS 25676

Open treatment of distal radioulnar dislocation, acute or chronic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.00 / $2,747.00 / $8,017.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$722.76 / $722.76 / $722.76
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,120.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$722.76 / $722.76 / $722.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.64 / $620.64 / $674.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00