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Pennsylvania rates for HCPCS 28800

Amputation Foot Midtarsal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$976.00 / $3,839.00 / $8,240.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.91 / $600.91 / $600.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,761.00 / $8,404.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.91 / $600.91 / $600.91
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.44 / $515.44 / $639.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,368.00