go back

South Carolina rates for HCPCS 25905

Amputation, forearm, through radius and ulna; open, circular (guillotine)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $724.44 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $18,197.01 / $34,673.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $831.76 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $977.24 / $1,548.82
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,621.81
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $20,417.38 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $724.44 / $1,318.26