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Utah rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Professionalmedian $191 · 10th–90th $105–$6920%10%10th90th$191$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $204.17 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $257.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $208.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $223.87 / $346.74
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $309.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $229.09