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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
$263.03 / $316.23 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $186.21 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $263.03 / $741.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $169.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $245.47 / $371.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $275.42 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,096.48 / $1,412.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $257.04 / $354.81