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Montana rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.59 / $177.46 / $581.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.62 / $177.19 / $248.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.09 / $173.18 / $261.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.26 / $205.38 / $308.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.03 / $252.00 / $287.36