Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC CL TX TARSAL BONE DISLO; WO ANESTH
Lititz, PA
See all hospitals reporting CPT 28540 →Price type
UPMC Lititz’s median price of $563 is 67% above the median hospital's median price ($337), higher than 72% of the 1,678 hospitals reporting CPT 28540. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 2 | Highmark medicare facility · fee schedule · outpatient | $228 | $228 | — | — | — | $228 – $228 |
| 3 | Aetna medicare facility · fee schedule · outpatient | $240 | $240 | — | — | — | $240 – $240 |
| 4 | Cigna medicare facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 5 | UnitedHealthcare medicare facility · fee schedule · outpatient | $247 | $247 | — | — | — | $247 – $247 |
| 6 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $253 | $253 | — | — | — | $253 – $253 |
| 7 | Highmark medicaid facility · fee schedule · outpatient | $430 | $430 | $279 | 65% | — | $151 – $709 |
| 8 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $473 | $473 | — | — | — | $473 – $473 |
| 9 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $497 | $497 | — | — | — | $497 – $497 |
| 10 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $563 | $563 | — | — | — | $563 – $563 |
| 11 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $592 | $592 | — | — | — | $592 – $592 |
| 12 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $593 | $593 | — | — | — | $593 – $593 |
| 13 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $593 | $593 | — | — | — | $593 – $593 |
| 14 | Highmark commercial - children's health insurance facility · fee schedule · outpatient | $681 | $681 | — | — | — | $681 – $681 |
| 15 | Highmark commercial facility · fee schedule · outpatient | $725 | $725 | — | — | — | $725 – $725 |
| 16 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $987 | $987 | — | — | — | $987 – $987 |
| 17 | UnitedHealthcare pa medicaid facility · fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 18 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 19 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
Last updated: Mar 6, 2026
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