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South Carolina rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $7,244.36 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $6,025.60 / $10,715.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $794.33 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $776.25 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $831.76 / $1,412.54
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,479.11
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $851.14 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $11,220.18 / $17,378.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $1,096.48