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Montana rates for HCPCS 28120

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,910.62 / $3,910.62 / $4,440.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.23 / $789.23 / $789.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.22 / $563.13 / $789.23