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Utah rates for HCPCS 28540

Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia

Facilitymedian $3,020 · 10th–90th $275–$4,5710%10%10th90th$3,020Professionalmedian $257 · 10th–90th $166–$1,0230%10%10th90th$257$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $251.19 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $251.19 / $323.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $346.74
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $467.74 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $457.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $331.13 / $398.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $309.03