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Pennsylvania rates for HCPCS 28575

Closed treatment of talotarsal joint dislocation; requiring anesthesia

Facilitymedian $2,692 · 10th–90th $661–$8,3180%5%10%10th90th$2,692Professionalmedian $372 · 10th–90th $309–$6610%20%40%10th90th$372$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$660.69 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $371.54 / $616.60
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $6,165.95 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $398.11 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $691.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $691.83 / $870.96
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $478.63 / $707.95
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,905.46 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $371.54 / $912.01
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $562.34 / $851.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $371.54
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $3,890.45 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $389.05 / $707.95