go back

Indiana rates for HCPCS 28555

Open Treatment Tarsal Bone Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.05 / $944.99 / $7,212.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,796.00 / $6,340.00 / $30,900.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.77 / $833.77 / $1,250.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,748.29 / $6,748.29 / $7,999.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.00 / $12,330.00 / $17,416.00