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Indiana 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
$367.91 / $2,318.00 / $11,093.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.83 / $376.06 / $622.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,473.00 / $7,890.00 / $30,900.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.89 / $491.98 / $698.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.02 / $505.12 / $757.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.80 / $451.00 / $649.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,035.70 / $7,035.70 / $8,340.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.43 / $616.39 / $883.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.00 / $12,330.00 / $17,416.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.34 / $450.55 / $808.51