go back

New York 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
$318.31 / $2,660.00 / $7,521.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.62 / $297.74 / $504.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,385.00 / $4,133.00 / $9,074.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.91 / $285.18 / $647.63
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.92 / $365.92 / $6,213.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.92 / $365.92 / $411.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.33 / $394.33 / $14,648.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.61 / $413.59 / $990.61
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.68 / $345.00 / $600.32
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.58 / $393.30 / $575.62
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.10 / $246.10 / $246.10
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.82 / $314.20 / $554.25
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.33 / $555.00 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.23 / $416.96 / $966.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$964.00 / $2,826.00 / $4,851.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.69 / $359.54 / $901.44
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.82 / $281.82 / $1,217.61
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.03 / $342.96 / $599.12