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Pennsylvania 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 $3,981 · 10th–90th $617$8,3180%10%10th90th$3,981Professionalmedian $603 · 10th–90th $427$1,3490%20%10th90th$603$5.0$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
$602.56 / $3,981.07 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $1,445.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $426.58
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,570.88 / $38,904.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,248.07 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $616.60 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $630.96 / $1,071.52
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $977.24 / $1,230.27
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $707.95 / $1,071.52
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,079.46 / $11,481.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $467.74 / $524.81
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,715.35 / $10,964.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,737.80 / $8,128.31
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $616.60 / $1,174.90
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $912.01 / $1,288.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $676.08
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $467.74 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $616.60 / $1,047.13