go back

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
$4,265.80 / $7,585.78 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $389.05 / $1,513.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $10,964.78 / $21,379.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $616.60 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $870.96 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $676.08 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $812.83 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $933.25 / $1,202.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $912.01 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $8,511.38 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $741.31 / $1,000.00