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Texas 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
$715.55 / $3,776.00 / $12,941.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,365.52 / $4,243.05 / $8,403.96
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,216.00 / $2,921.45 / $4,310.50
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.66 / $2,678.82 / $2,678.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.64 / $843.64 / $843.64
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,345.80 / $11,500.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.14 / $681.32 / $1,095.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.86 / $682.14 / $1,121.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.00 / $3,326.00 / $7,600.00