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Idaho 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
$2,884.03 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $489.78 / $812.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $7,585.78 / $18,620.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $776.25 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $6,309.57 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $524.81 / $707.95
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $691.83 / $1,071.52
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $676.08 / $912.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $16,218.10 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $741.31 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $446.68 / $13,489.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $11,748.98 / $29,512.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $588.84 / $812.83