go back

Vermont rates for HCPCS 28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $147.91 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $199.53 / $281.84
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $218.78 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $181.97 / $380.19