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Pennsylvania rates for HCPCS 28615

Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$859.42 / $3,838.00 / $14,180.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,639.91 / $11,851.00 / $26,582.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$939.63 / $939.63 / $939.63
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$93.73 / $93.73 / $93.73
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,845.60 / $15,458.11 / $24,092.03
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,194.00 / $13,908.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$939.63 / $939.63 / $939.63
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$93.73 / $93.73 / $93.73
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$734.48 / $808.38 / $808.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00