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Alaska rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.64 / $550.92 / $741.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.37 / $373.95 / $669.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.95 / $459.96 / $924.30
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.00 / $628.00 / $904.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.26 / $598.50 / $898.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.68 / $702.94 / $883.70