go back

Wisconsin rates for HCPCS 25690

Closed treatment of lunate dislocation, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $1,023.29 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $501.19 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $1,000.00 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $2,041.74 / $2,344.23
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $977.24 / $3,548.13
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,202.26 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,023.29 / $5,248.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $851.14 / $3,715.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,148.15 / $1,737.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $3,235.94 / $4,786.30
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $2,344.23 / $3,630.78
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,691.53 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $3,801.89 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $707.95 / $1,995.26