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New Hampshire rates for HCPCS 28575

Closed treatment of talotarsal joint dislocation; requiring anesthesia

Facilitymedian $1,820 · 10th–90th $1,072–$9,7720%10%20%10th90th$1,820Professionalmedian $513 · 10th–90th $347–$9550%10%10th90th$513$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $416.87 / $776.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $549.54 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $616.60 / $1,096.48
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $645.65 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $575.44 / $1,122.02
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $478.63