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Idaho rates for HCPCS 28104

Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.16 / $1,276.61 / $7,205.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,895.78 / $1,895.78 / $1,901.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$356.24 / $727.82 / $1,137.16
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,515.72 / $7,849.65 / $9,927.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $5,550.00 / $12,233.00