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Utah rates for HCPCS 25690

Closed treatment of lunate dislocation, with manipulation

Facilitymedian $3,162 · 10th–90th $2,239–$4,5710%10%20%10th90th$3,162Professionalmedian $661 · 10th–90th $457–$2,8180%10%10th90th$661$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $933.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $380.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,162.28 / $4,786.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $1,174.90
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $912.01 / $1,174.90
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $758.58 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $501.19 / $831.76