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Louisiana 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
$593.00 / $1,417.20 / $3,685.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,533.66 / $9,322.27 / $13,354.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $597.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$725.00 / $725.00 / $725.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $5,780.00 / $13,506.00