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Indiana rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$592.82 / $1,941.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.66 / $595.10 / $815.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.72 / $434.72 / $434.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,796.00 / $6,340.00 / $30,900.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.79 / $807.60 / $1,114.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.86 / $811.48 / $1,217.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.63 / $695.56 / $1,043.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,705.12 / $4,705.12 / $5,577.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.67 / $821.30 / $1,315.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,032.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.41 / $693.30 / $1,221.81