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Missouri rates for HCPCS 23665

Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.91 / $3,213.00 / $7,365.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$257.66 / $280.36 / $364.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.81 / $607.38 / $2,020.00
Medica
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$1,330.94 / $1,330.94 / $1,330.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $1,291.00 / $2,539.00