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Oklahoma 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
$1,150.00 / $3,821.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.51 / $410.13 / $410.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,409.25 / $10,182.03 / $16,087.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.85 / $504.01 / $592.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,463.35 / $8,463.35 / $8,463.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$419.59 / $549.29 / $722.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.13 / $636.23 / $14,063.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.80 / $466.50 / $3,959.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,851.00 / $7,074.00 / $14,139.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.52 / $425.93 / $602.61