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Virginia rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,088.00 / $3,645.00 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.23 / $670.39 / $1,146.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,823.00 / $12,004.00 / $15,528.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.28 / $761.24 / $1,258.55
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.83 / $727.12 / $7,889.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.00 / $572.00 / $726.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.90 / $838.66 / $1,389.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.00 / $786.38 / $929.36
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$664.87 / $840.00 / $1,226.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.00 / $891.70 / $1,230.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.10 / $802.32 / $2,704.91
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.10 / $802.32 / $2,704.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,651.00 / $6,870.00 / $12,739.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.79 / $782.27 / $1,221.93