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Open Surgery For A Broken Sesamoid Bone Of The Foot

Maine rates for HCPCS 28531

Opens the ball of the foot beneath the big toe through an incision to treat a fracture of a sesamoid, one of the two small bones embedded in the tendon there. The surgeon exposes the broken bone, repositions the pieces and secures them with small hardware when that is needed, or removes a fragment that cannot be salvaged. It is chosen when protecting the foot alone has not settled the pain or the fragments will not stay in place.

Rates data updated July 2026.

How much does Open Surgery For A Broken Sesamoid Bone Of The Foot cost?

$339

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $339 for this service. Most negotiated rates run $219 to $417.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $14,791 · 10th to 90th $14,791 to $14,791Professionalmedian $339 · 10th to 90th $191 to $617
$200$500$1K$2K$5K$10Kfacility $14,791professional $339

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$389.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$275.42
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$371.54
Typical High
$707.95
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$398.11
Typical High
$676.08
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$263.03
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$14,791.08
Median
$14,791.08
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$346.74
Typical High
$630.96

Where Maine sits

The same service costs 7.6 times more in Hawaii than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 32nd of 51

$339

HI $2,239KY $295

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.