go back

Idaho rates for HCPCS 26502

Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,000.00 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $4,570.88 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $954.99 / $1,288.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,258.93 / $1,995.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,380.38 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $7,244.36 / $10,232.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $1,621.81
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $851.14 / $6,309.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $9,332.54 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,047.13 / $1,479.11