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Pennsylvania rates for HCPCS 25685

Open treatment of trans-scaphoperilunar type of fracture dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,142.00 / $7,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.95 / $744.63 / $1,086.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.12 / $793.00 / $1,345.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.32 / $840.32 / $840.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$689.30 / $892.38 / $1,491.87
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.44 / $1,192.05 / $1,519.03
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.29 / $829.29 / $829.29
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $3,839.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.95 / $826.82 / $3,654.69
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$909.00 / $957.10 / $1,510.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.32 / $840.32 / $840.32
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.99 / $921.93 / $1,523.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$722.63 / $722.63 / $776.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.32 / $726.26 / $776.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.48 / $866.66 / $1,375.25