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Wisconsin rates for HCPCS 25680

Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,122.02 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $549.54 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,090.30 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $1,023.29 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $2,187.76 / $2,511.89
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,023.29 / $3,981.07
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,288.25 / $1,584.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $977.24 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $851.14 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,230.27 / $1,905.46
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $1,380.38 / $3,388.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $2,511.89 / $3,890.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $2,951.21 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,548.82 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $741.31 / $2,089.30