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Michigan rates for HCPCS 28455

Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.24 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.56 / $294.26 / $386.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.50 / $333.36 / $468.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.02 / $282.45 / $571.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.32 / $322.04 / $562.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.94 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.62 / $289.94 / $436.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.98 / $185.27 / $282.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,418.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.94 / $343.93 / $465.15