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Montana rates for HCPCS 25685

Open treatment of trans-scaphoperilunar type of fracture dislocation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.11 / $785.11 / $3,852.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,177.27 / $1,177.27 / $1,177.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,177.27 / $1,177.27 / $1,177.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.22 / $1,177.27 / $1,234.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$583.38 / $802.15 / $1,177.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.79 / $1,177.27 / $1,533.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.34 / $1,217.92 / $1,387.97