go back

Tennessee 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
$891.25 / $2,398.83 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $426.58 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,606.93 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $602.56 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $575.44 / $870.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,512.09 / $29,512.09 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $7,585.78 / $12,302.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $501.19 / $831.76