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New Hampshire 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 / $1,862.09 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $630.96 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $758.58 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $891.25 / $1,737.80
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $851.14 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $812.83 / $1,479.11
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $724.44