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Washington, DC rates for HCPCS 28540

Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $2,754.23 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $190.55 / $524.81
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $288.40 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $251.19 / $501.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $398.11 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $549.54 / $1,548.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $251.19 / $501.19