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Virginia 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 / $2,818.38 / $7,079.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,888.44 / $6,760.83 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $794.33
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $707.95 / $1,230.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $562.34 / $933.25
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $467.74 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $7,079.46 / $14,125.38