go back

New Hampshire 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
$407.38 / $1,778.28 / $6,025.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,677.35 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $1,819.70
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $645.65