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Louisiana 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
$724.44 / $1,949.84 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $645.65 / $1,479.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $234.42 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,786.30 / $6,456.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $707.95 / $933.25
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $707.95 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $977.24