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South Carolina rates for HCPCS 28455

Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.27 / $3,776.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.11 / $299.37 / $382.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.64 / $435.63 / $842.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.62 / $297.75 / $509.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $233.24 / $394.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.95 / $361.10 / $630.73
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.26 / $368.39 / $574.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.45 / $274.45 / $274.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.89 / $196.92 / $326.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $1,221.00 / $3,585.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.05 / $301.55 / $581.37