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Vermont rates for HCPCS 28540

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $223.87 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $269.15 / $398.11
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $288.40 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $251.19 / $457.09