go back

South Carolina 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
$575.44 / $5,495.41 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $602.56 / $1,148.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $416.87 / $758.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,365.16 / $8,912.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $602.56 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $758.58 / $2,570.40
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
$501.19 / $691.83 / $1,148.15
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,380.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $691.83 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $11,220.18 / $16,982.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $588.84 / $1,000.00