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California rates for HCPCS 28490

Cltx Fx Grt Toe Phlx/Phlg W/O Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.00 / $4,704.00 / $16,125.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$85.38 / $99.12 / $686.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.84 / $132.97 / $449.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.90 / $59.90 / $131.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,723.00 / $4,464.00 / $8,976.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.99 / $152.16 / $300.33
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $1,581.82
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $133.88 / $301.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.00 / $198.82 / $356.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.37 / $173.16 / $361.40
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.06 / $162.82 / $224.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.91 / $186.45 / $325.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $605.96 / $681.25
Lucent Health
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$416.44 / $476.87 / $476.87
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$943.20 / $1,086.00 / $1,251.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.83 / $177.92 / $244.92
Providence
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$149.84 / $149.84 / $269.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.96 / $182.83 / $363.21
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.00 / $412.00 / $474.51
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.91 / $148.04 / $208.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.00 / $1,533.00 / $6,323.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.89 / $144.16 / $330.26