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Nebraska 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
$912.01 / $6,165.95 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $870.96 / $2,344.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $616.60 / $812.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $10,964.78 / $21,379.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $794.33 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,148.15 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $812.83 / $4,265.80
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
$616.60 / $1,148.15 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,348.96 / $1,778.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,318.26 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $4,897.79 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $912.01 / $1,412.54