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Arkansas rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $141.25 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $158.49 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $181.97 / $257.04
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $251.19