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South Dakota rates for HCPCS 28455

Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each

Facilitymedian $417 · 10th–90th $269–$4,3650%10%20%10th90th$417Professionalmedian $339 · 10th–90th $240–$6310%10%10th90th$339$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $776.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $446.68 / $660.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $616.60 / $1,949.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $602.56 / $660.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $562.34 / $645.65
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $446.68 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $457.09 / $776.25
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $562.34 / $616.60