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Idaho 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 / $158.49 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $229.09 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $186.21 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $275.42 / $346.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $229.09 / $323.59
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $199.53 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $186.21 / $288.40