go back

Texas 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
$812.83 / $3,548.13 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $416.87 / $691.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $9,549.93 / $18,620.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $416.87 / $588.84
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $8,511.38 / $8,511.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $549.54 / $891.25
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,512.09 / $45,708.82 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $645.65 / $3,890.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $489.78 / $660.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $331.13
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $794.33 / $794.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $562.34 / $912.01
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $537.03 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $8,317.64 / $17,378.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $426.58 / $676.08
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $371.54 / $371.54