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Utah rates for HCPCS 28575

Closed treatment of talotarsal joint dislocation; requiring anesthesia

Facilitymedian $3,162 · 10th–90th $479–$6,0260%10%10th90th$3,162Professionalmedian $447 · 10th–90th $324–$1,9500%10%10th90th$447$50.0$200.0$1.0K$5.0K

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
$478.63 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $616.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $575.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $6,309.57 / $9,772.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $588.84 / $851.14
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $645.65 / $741.31
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $575.44