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Indiana 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
$248.81 / $543.00 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.49 / $260.30 / $368.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$970.00 / $5,790.87 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $286.24 / $397.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.09 / $280.92 / $325.88
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.25 / $288.30 / $360.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.18 / $191.18 / $226.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.61 / $321.33 / $533.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.77 / $307.41 / $542.57