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Maryland rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $144.54 / $398.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $128.82 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $208.93 / $309.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $151.36 / $281.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $208.93 / $257.04