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Open Surgery For A Broken Sesamoid Bone Of The Foot

West Virginia 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?

$295

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $302 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$295$186 to $347
FacilityA hospital or hospital-owned outpatient department$302$174 to $302

How much rates vary

Facilitymedian $302 · 10th to 90th $174 to $1,738Professionalmedian $295 · 10th to 90th $162 to $389
$200$500$1K$2K$5K$10K$20Kfacility $302professional $295

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$302.00
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$295.12
Typical High
$389.05
CareSource
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$229.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$354.81
Typical High
$3,235.94
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,951.21
Typical High
$20,417.38
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$288.40
Typical High
$549.54

Where West Virginia 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.

West Virginia· 50th of 51

$295

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.