go back

Tennessee rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.46 / $139.75 / $242.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.38 / $178.77 / $281.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.26 / $181.54 / $297.02
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$816.00 / $1,135.68 / $1,330.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.72 / $173.38 / $327.11