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Virginia 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
$839.75 / $3,116.00 / $8,294.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,823.00 / $12,004.00 / $15,528.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.00 / $572.00 / $1,109.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.92 / $1,031.81 / $1,219.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.00 / $974.19 / $1,548.38
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.97 / $823.27 / $2,835.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,408.00 / $13,296.00 / $26,537.00