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Missouri 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
$305.77 / $2,507.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.56 / $271.29 / $422.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $5,295.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.09 / $307.00 / $454.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.77 / $356.32 / $587.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.03 / $374.52 / $812.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.77 / $433.07 / $1,970.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $815.00 / $1,351.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.61 / $349.73 / $614.01