go back

Idaho rates for HCPCS 25695

Open Treatment Lunate Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.00 / $4,500.00 / $7,205.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.16 / $885.17 / $1,295.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,214.76 / $4,214.76 / $4,226.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.98 / $960.40 / $1,111.36
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$611.98 / $1,148.67 / $1,496.43
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,042.88 / $1,137.69 / $1,487.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $889.81 / $1,119.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,138.70 / $17,361.59 / $22,059.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,097.35 / $1,291.01 / $1,487.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $5,550.00 / $12,233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.50 / $943.63 / $1,354.20