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Washington rates for HCPCS 28455

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

Facilitymedian $550 · 10th–90th $282–$7,9430%10%20%10th90th$550Professionalmedian $372 · 10th–90th $240–$7080%10%20%10th90th$372$20.0$100.0$500.0$2.0K$10.0K

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
$446.68 / $758.58 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $707.95
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,265.80 / $8,709.64
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $512.86 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $446.68 / $758.58
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $724.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $125.89
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $562.34
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $380.19 / $389.05
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $467.74 / $707.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,466.84 / $8,709.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $501.19 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $5,011.87 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $724.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $302.00 / $478.63