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Montana rates for HCPCS 28122

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus

Facilitymedian $977 · 10th–90th $741–$6,6070%20%10th90th$977Professionalmedian $776 · 10th–90th $447–$2,0890%10%10th90th$776$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $8,912.51 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $741.31 / $2,290.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,071.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $1,174.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $741.31 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $831.76 / $1,122.02