go back

Alaska rates for HCPCS 25690

Closed treatment of lunate dislocation, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,464.00 / $6,782.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.63 / $2,375.84 / $2,375.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,184.14 / $1,562.32 / $2,149.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$473.40 / $2,375.84 / $3,326.18
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.50 / $1,488.60 / $3,021.98
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,733.75 / $2,381.75 / $3,038.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$473.40 / $2,375.84 / $3,326.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.50 / $2,380.00 / $3,038.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.85 / $2,187.26 / $2,749.69