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Wisconsin rates for HCPCS 28104

Exc/Curtg Bone Cyst/B9 Tumortarsal/Metatarsal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.93 / $1,331.24 / $6,980.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,462.54 / $3,462.54 / $3,462.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,405.75 / $1,642.73 / $2,519.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.93 / $563.87 / $1,091.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $680.08 / $7,160.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.93 / $563.87 / $1,091.03
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.23 / $1,208.11 / $1,780.73
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,682.60 / $1,682.60 / $3,244.77
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$165.01 / $165.01 / $165.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,103.00 / $6,477.00 / $8,384.00