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Pennsylvania 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
$540.00 / $2,747.00 / $7,799.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,292.00 / $5,951.00 / $9,100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.79 / $608.79 / $608.79
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.88 / $60.88 / $60.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,037.87 / $8,125.19 / $10,942.35
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.00 / $3,077.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.79 / $608.79 / $608.79
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.88 / $60.88 / $60.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.64 / $442.87 / $504.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00