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Maryland rates for HCPCS 28555

Open Treatment Tarsal Bone Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.02 / $52.02 / $12,927.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $453.73 / $4,753.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$880.16 / $1,135.41 / $1,500.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,003.00 / $1,003.00 / $2,156.00