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Michigan rates for HCPCS 25685

Open treatment of trans-scaphoperilunar type of fracture dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $741.31 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,698.24 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,202.26 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $870.96 / $2,137.96
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $4,073.80 / $5,754.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $831.76 / $1,174.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $870.96 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,623.41 / $14,454.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $870.96 / $1,148.15