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Oregon rates for HCPCS 28555

Open Treatment Tarsal Bone Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,473.57 / $2,747.00 / $7,920.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.00 / $736.00 / $736.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.08 / $1,648.70 / $2,052.53
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.18 / $1,319.06 / $1,983.96
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,009.20 / $1,564.33 / $1,744.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.18 / $1,363.41 / $2,461.17
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,860.72 / $22,602.85 / $28,333.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $18,628.00 / $26,255.00