go back

New York 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
$546.28 / $4,392.00 / $10,024.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.14 / $405.93 / $823.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,749.00 / $9,877.00 / $16,490.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.66 / $403.49 / $936.73
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.83 / $1,990.00 / $8,917.50
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.83 / $549.83 / $549.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.04 / $443.04 / $443.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.20 / $643.48 / $1,396.24
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $640.00 / $1,024.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.66 / $581.51 / $849.35
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.96 / $368.96 / $368.96
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.05 / $400.41 / $830.97
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$988.94 / $988.94 / $5,943.88
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.83 / $546.83 / $719.44
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.04 / $555.00 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.95 / $650.92 / $1,366.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,341.00 / $6,700.00 / $16,782.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.34 / $499.74 / $1,189.55
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.07 / $471.07 / $2,114.06
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.96 / $514.19 / $995.76