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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
$549.54 / $3,715.35 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,248.07 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.26 / $60.26 / $60.26
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $8,912.51 / $10,715.19
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $2,818.38 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $1,096.48
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $416.87 / $501.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,548.13 / $10,000.00