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Michigan 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
$848.65 / $2,877.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,199.62 / $7,276.53 / $9,858.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$893.41 / $1,444.44 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,635.00 / $10,192.00 / $12,767.00