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Indiana rates for HCPCS 28490

Cltx Fx Grt Toe Phlx/Phlg W/O Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.33 / $514.08 / $5,634.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$88.75 / $100.55 / $169.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.09 / $132.15 / $199.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.96 / $169.28 / $173.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$856.00 / $4,320.00 / $8,230.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.03 / $118.73 / $168.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.26 / $165.06 / $247.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.69 / $160.44 / $240.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.68 / $135.68 / $160.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.81 / $157.16 / $256.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.60 / $153.13 / $269.83