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Indiana 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
$549.54 / $3,548.13 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $588.84 / $1,258.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $407.38 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $13,803.84 / $19,054.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $562.34 / $977.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $446.68 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $758.58 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $645.65 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $6,025.60 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $588.84 / $1,023.29