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South Carolina 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 / $147.91 / $245.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $162.18 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $177.83 / $295.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $363.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $144.54 / $239.88