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Pennsylvania rates for HCPCS 28490

Closed treatment of fracture great toe, phalanx or phalanges; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $162.18 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $194.98
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $151.36 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $158.49 / $269.15
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $263.03 / $331.13
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $162.18 / $263.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $1,023.29 / $1,380.38
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $151.36 / $169.82
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $2,089.30 / $7,762.47
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $177.83 / $363.08
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $295.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $158.49 / $331.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $120.23 / $138.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $120.23 / $158.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $676.08 / $3,890.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $151.36 / $251.19