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Missouri 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
$616.60 / $3,162.28 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $691.83 / $2,630.27
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $446.68 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,677.35 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $588.84 / $870.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $602.56 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $707.95 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $776.25 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$204.17 / $204.17 / $204.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $912.01 / $4,466.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,630.27 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $616.60 / $977.24