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Minnesota 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
$446.68 / $1,778.28 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $602.56 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $6,456.54 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,202.26 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,187.76 / $5,248.07
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,548.82 / $2,511.89
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,089.30 / $4,168.69
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,479.11 / $2,398.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $933.25 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,230.27 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $4,786.30 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $933.25 / $1,819.70