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Florida rates for HCPCS 28455

Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.09 / $2,815.00 / $10,632.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.78 / $268.81 / $367.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.22 / $142.19 / $169.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.77 / $342.43 / $540.02
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,754.00 / $6,711.00 / $12,042.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.61 / $249.26 / $327.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.27 / $197.34 / $312.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.00 / $1,950.00 / $5,107.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.77 / $298.68 / $530.69
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.02 / $201.71 / $201.71