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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
$764.65 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.83 / $385.68 / $624.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.58 / $685.58 / $685.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,430.00 / $5,467.00 / $9,272.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.23 / $532.78 / $817.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.57 / $572.28 / $835.18
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,439.16 / $26,542.00 / $29,777.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,959.35 / $3,959.35 / $3,959.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,964.00 / $8,273.00 / $12,407.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.80 / $503.68 / $891.81