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Utah rates for HCPCS 25905

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

Facilitymedian $4,467 · 10th–90th $1,023–$23,9880%20%10th90th$4,467Professionalmedian $1,023 · 10th–90th $646–$3,8900%20%10th90th$1,023$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,023.29 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $537.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $25,118.86 / $37,153.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,174.90 / $1,621.81
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,288.25 / $1,698.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,047.13 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $741.31 / $1,202.26