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New York rates for HCPCS 28531

Open treatment of sesamoid fracture, with or without internal fixation

Facilitymedian $5,248 · 10th–90th $355–$13,8040%5%10th90th$5,248Professionalmedian $347 · 10th–90th $182–$8320%5%10%10th90th$347$100.0$500.0$2.0K$10.0K$50.0K

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
$281.84 / $3,311.31 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $309.03 / $724.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $11,220.18 / $18,620.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $346.74 / $831.76
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $1,995.26 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $1,862.09 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $416.87 / $1,071.52
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $380.19 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $537.03 / $724.44
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $426.58 / $691.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $9,772.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $389.05 / $1,122.02
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $831.76
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $416.87 / $776.25