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Nebraska rates for HCPCS 28455

Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.52 / $3,908.01 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.51 / $276.52 / $1,373.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,350.61 / $4,406.97 / $8,524.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.94 / $384.80 / $527.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.98 / $213.98 / $213.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.00 / $582.47 / $841.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.88 / $456.04 / $1,103.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.25 / $602.55 / $1,761.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.37 / $563.70 / $805.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.44 / $597.03 / $802.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.25 / $587.53 / $765.16