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Montana rates for HCPCS 28555

Open treatment of tarsal bone dislocation, includes internal fixation, when performed

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,056.33 / $1,056.33 / $1,056.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.58 / $730.40 / $1,178.38