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Utah rates for HCPCS 28570

Closed treatment of talotarsal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $245.47 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $234.42 / $446.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $323.59
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $398.11 / $870.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $354.81 / $501.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $371.54 / $467.74
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $354.81 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $208.93 / $331.13