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Idaho 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
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $229.09 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $263.03 / $616.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $363.08 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $257.04 / $338.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $302.00 / $489.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $338.84 / $426.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $524.81 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $363.08 / $407.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $281.84 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $1,819.70 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $269.15 / $389.05