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Vermont 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
$4,570.88 / $4,570.88 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $676.08 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $794.33 / $1,096.48
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $851.14 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $812.83 / $1,445.44