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Indiana 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
$281.84 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $190.55 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $4,466.84 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $199.53 / $323.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $181.97 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $257.04 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $213.80 / $338.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $2,137.96 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $199.53 / $346.74