go back

Maine rates for HCPCS 25924

Disarticulation Thru Wrist Re-Amputation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.01 / $763.06 / $880.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,744.96 / $31,420.90 / $36,545.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.85 / $947.10 / $1,375.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.10 / $1,056.66 / $1,560.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.60 / $1,039.68 / $1,594.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.01 / $738.01 / $880.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.70 / $845.99 / $1,440.32