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Arizona rates for HCPCS 28805

Amputation, foot; transmetatarsal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $3,641.50 / $7,467.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,640.00 / $10,860.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.64 / $891.49 / $3,787.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$182.01 / $182.01 / $736.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,343.00 / $3,339.00 / $5,838.00