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Alaska rates for HCPCS 28103

Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,741.00 / $10,480.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.24 / $1,159.67 / $1,966.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$990.18 / $1,342.64 / $1,661.57
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.94 / $1,966.84 / $2,753.58
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$952.60 / $1,143.11 / $2,320.66
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,406.25 / $1,933.28 / $2,338.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.94 / $1,966.84 / $2,753.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.26 / $1,899.15 / $2,475.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.11 / $1,840.97 / $2,363.06