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Idaho rates for HCPCS 28555

Open Treatment Tarsal Bone Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.00 / $1,456.44 / $7,205.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,045.00 / $6,045.00 / $6,061.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$646.01 / $1,290.64 / $1,929.77
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,951.56 / $17,361.59 / $22,059.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,600.00 / $11,800.00 / $29,092.00