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West Virginia rates for HCPCS 28635

Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $165.96 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $158.49 / $234.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $165.96
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $204.17 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $251.19