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Maine rates for HCPCS 28575

Closed Tx Talotarsal Joint Dislocation W/Anes

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.95 / $365.78 / $575.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.27 / $460.73 / $647.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.23 / $539.03 / $787.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.82 / $526.95 / $869.90
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.95 / $383.36 / $470.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.26 / $499.94 / $787.91