go back

New York rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.21 / $3,841.00 / $9,038.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.27 / $664.87 / $1,216.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,749.00 / $9,877.00 / $16,490.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.01 / $651.00 / $1,523.21
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.35 / $1,716.00 / $6,213.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.35 / $900.35 / $900.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$726.86 / $726.86 / $726.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.36 / $957.72 / $2,400.89
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $691.71 / $1,712.97
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.61 / $994.61 / $1,469.35
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.64 / $601.64 / $601.64
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.65 / $652.05 / $1,353.23
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $726.86
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.16 / $957.72 / $2,215.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,031.00 / $4,840.00 / $9,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.37 / $791.61 / $1,997.62
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.13 / $767.13 / $2,934.26
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.25 / $838.45 / $1,621.58