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Wisconsin rates for HCPCS 28800

Amputation Foot Midtarsal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.16 / $1,096.56 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,633.00 / $15,923.00 / $22,428.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,382.32 / $1,615.35 / $2,477.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.16 / $778.76 / $1,147.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.16 / $1,074.89 / $11,100.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.16 / $744.68 / $1,147.36
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,039.34 / $1,266.41 / $1,890.50
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,485.76 / $2,485.76 / $2,485.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00