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Michigan 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
$588.84 / $4,073.80 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $616.60 / $1,479.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $389.05 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $954.99 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $616.60 / $1,047.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $4,073.80 / $8,128.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $676.08 / $1,174.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $562.34 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $4,786.30 / $8,709.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $630.96 / $831.76