go back

Massachusetts 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
$575.44 / $2,951.21 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $660.69 / $1,905.46
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,897.79 / $45,708.82
AllWays Health Partners
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$891.25 / $891.25 / $891.25
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $794.33 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $912.01 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $851.14 / $1,479.11
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $912.01 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $1,174.90
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,265.80 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $870.96 / $1,548.82
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $4,365.16 / $4,365.16
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $562.34 / $691.83
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,897.79 / $45,708.82
Mass General Brigham
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$891.25 / $891.25 / $891.25
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $794.33 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $4,265.80 / $9,772.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $831.76 / $1,584.89