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Utah rates for HCPCS 28103

Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft

Facilitymedian $6,026 · 10th–90th $3,162–$10,2330%10%10th90th$6,026Professionalmedian $575 · 10th–90th $355–$1,6600%10%20%10th90th$575$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $575.44 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $549.54 / $831.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $691.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $14,125.38 / $21,379.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $645.65 / $1,288.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $724.44 / $933.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $575.44 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $426.58 / $707.95