go back

Michigan rates for HCPCS 25690

Closed treatment of lunate dislocation, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.29 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.96 / $632.29 / $656.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,394.84 / $1,637.13 / $2,218.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.94 / $572.92 / $1,274.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.75 / $560.15 / $1,052.08
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$484.62 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.62 / $544.76 / $795.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $363.97 / $590.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $3,640.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.85 / $566.84 / $766.62