go back

Wisconsin rates for HCPCS 28615

Open Treatment Tarsometatarsal Joint Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$811.85 / $2,098.04 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,287.00 / $13,743.77 / $21,606.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,149.74 / $10,149.74 / $10,149.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,182.51 / $2,550.44 / $3,912.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.98 / $984.38 / $1,902.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.98 / $1,636.11 / $15,090.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.98 / $984.38 / $1,902.45
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,641.90 / $2,000.59 / $2,986.49
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,216.78 / $9,216.78 / $25,442.40
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$2,411.58 / $2,411.58 / $2,411.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,627.00 / $12,373.00 / $15,090.00