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Illinois rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$653.09 / $1,842.00 / $5,389.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $653.09 / $1,181.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,564.71 / $10,028.23 / $15,271.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.04 / $1,081.39 / $1,316.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.00 / $6,831.39 / $7,626.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.65 / $942.55 / $1,353.68
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.33 / $1,072.26 / $2,864.98
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.92 / $815.17 / $907.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,026.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,499.00 / $3,751.00 / $6,514.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.40 / $820.76 / $1,409.14