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Utah rates for HCPCS 28645

Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $5,888.44 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $660.69 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $724.44 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $933.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $12,589.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,000.00 / $1,548.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $954.99 / $1,288.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $602.56 / $954.99