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Nebraska 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
$4,083.97 / $8,477.27 / $19,276.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.14 / $364.64 / $1,966.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,362.84 / $10,999.42 / $21,276.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.58 / $604.40 / $805.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,874.79 / $7,874.79 / $7,874.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.00 / $898.30 / $1,187.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.64 / $692.82 / $8,892.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.71 / $835.72 / $1,103.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.92 / $1,045.69 / $9,449.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.76 / $857.34 / $1,187.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,777.00 / $8,220.00 / $9,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.71 / $837.43 / $1,061.23