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Tennessee 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 / $2,398.83 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $602.56 / $1,174.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $407.38 / $602.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,073.80 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $794.33 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $707.95 / $1,122.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $8,912.51 / $45,708.82
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$891.25 / $891.25 / $891.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,897.79 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $3,630.78 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $630.96 / $1,096.48