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Delaware 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
$3,235.94 / $3,235.94 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $194.98 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $208.93 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $194.98 / $316.23