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Arizona rates for HCPCS 28555

Open treatment of tarsal bone dislocation, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,274.51 / $2,897.00 / $6,483.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.35 / $2,211.19 / $3,616.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.84 / $852.92 / $7,167.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,279.00 / $7,341.00 / $11,396.00