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New York 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
$602.56 / $3,890.45 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $676.08 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $5,888.44 / $12,302.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $1,513.56
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,995.26 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $616.60 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $50,118.72
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
$457.09 / $794.33 / $2,041.74
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $489.78 / $1,230.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $954.99 / $1,348.96
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $776.25 / $1,258.93
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,311.31 / $6,456.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $512.86 / $676.08
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $794.33 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $4,365.16 / $9,549.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $645.65 / $1,548.82
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $537.03 / $2,398.83
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $741.31 / $1,584.89