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Pennsylvania rates for HCPCS 25900

Amputation, forearm, through radius and ulna;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.95 / $2,747.00 / $8,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.90 / $727.92 / $1,062.39
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.31 / $763.26 / $1,288.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.20 / $823.20 / $823.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.85 / $903.56 / $1,465.65
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.32 / $1,165.11 / $1,487.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $4,761.00 / $8,427.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.11 / $764.09 / $2,843.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.90 / $977.90 / $1,471.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.20 / $823.20 / $823.20
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.85 / $923.96 / $1,483.45
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$703.35 / $703.35 / $884.37
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.42 / $706.09 / $884.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.58 / $872.73 / $1,329.92