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Pennsylvania rates for HCPCS 28260

Capsulotomy, midfoot; medial release only (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.86 / $2,747.00 / $7,263.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$916.89 / $916.89 / $916.89
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$91.69 / $91.69 / $91.69
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.31 / $3,838.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$916.89 / $916.89 / $916.89
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$91.69 / $91.69 / $91.69
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$521.85 / $604.57 / $707.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00