go back

Minnesota 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
$269.15 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $275.42 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $3,801.89 / $8,128.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $575.44 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $977.24 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $758.58 / $1,148.15
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $933.25 / $1,819.70
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $660.69 / $1,071.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $467.74 / $812.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $575.44 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,862.09 / $4,168.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $489.78 / $954.99