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New York 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
$489.78 / $3,090.30 / $7,762.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $5,888.44 / $12,302.69
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,698.24 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.26 / $60.26 / $60.26
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $537.03 / $1,288.25
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,238.72 / $4,677.35
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $4,365.16 / $9,549.93
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $426.58 / $1,698.24