go back

New Mexico 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
$300.55 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.25 / $300.55 / $378.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.59 / $614.54 / $1,001.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.15 / $277.02 / $487.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.87 / $386.99 / $510.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $44.10 / $367.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.30 / $307.39 / $399.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.42 / $414.63 / $678.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.72 / $413.50 / $619.36