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Missouri rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.34 / $141.53 / $246.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.62 / $138.69 / $202.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.59 / $181.33 / $307.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.71 / $235.25 / $1,166.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.71 / $194.45 / $333.06