go back

Utah rates for HCPCS 25907

Amputation, forearm, through radius and ulna; secondary closure or scar revision

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $851.14 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $851.14 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,023.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $12,589.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,174.90 / $1,548.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $1,148.15 / $1,479.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,000.00 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $1,047.13