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South Dakota 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
$660.69 / $870.96 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,230.27 / $1,995.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,513.56 / $1,995.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,288.25 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32