go back

Michigan 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
$478.63 / $1,862.09 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $537.03 / $537.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,479.11 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $4,786.30 / $8,709.64