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Wisconsin rates for HCPCS 25685

Open treatment of trans-scaphoperilunar type of fracture dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,513.56 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $758.58 / $2,187.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $7,943.28 / $12,589.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,479.11 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,238.72 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $2,951.21 / $3,388.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,445.44 / $5,495.41
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,778.28 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,513.56 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,318.26 / $5,495.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,511.89
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $13,489.63 / $19,952.62
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $3,467.37 / $5,370.32
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,344.23
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $4,073.80 / $4,677.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,096.48 / $3,019.95