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Maine rates for HCPCS 28103

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $416.87 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $575.44 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $575.44 / $891.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $537.03 / $1,023.29
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $524.81 / $851.14