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New Mexico 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
$201.59 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.27 / $187.63 / $321.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.99 / $269.68 / $357.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $33.83 / $281.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.83 / $210.24 / $273.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.73 / $286.58 / $452.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.56 / $286.14 / $451.17