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Indiana rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.21 / $139.91 / $188.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.89 / $120.07 / $170.49
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.96 / $170.35 / $212.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.32 / $165.29 / $266.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.27 / $166.10 / $321.26