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Idaho rates for HCPCS 28122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $5,128.61 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $707.95 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $3,162.28 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $954.99 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $724.44 / $1,023.29
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $870.96 / $1,479.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $7,244.36 / $10,232.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $912.01 / $1,258.93
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $812.83 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $5,495.41 / $12,302.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $741.31 / $1,148.15