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Oklahoma 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
$682.00 / $3,683.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.56 / $271.77 / $304.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,182.21 / $1,878.12 / $2,967.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.40 / $338.34 / $408.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.97 / $229.97 / $229.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.55 / $337.89 / $435.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.66 / $359.18 / $1,145.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.72 / $328.31 / $1,970.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $610.00 / $1,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.77 / $298.45 / $433.39