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Wisconsin 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 $6,607 · 10th–90th $891$11,4820%10%20%10th90th$6,607Professionalmedian $794 · 10th–90th $427$2,5120%10%20%10th90th$794$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$588.84 / $5,011.87 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $660.69 / $2,089.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,943.28 / $12,589.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $870.96 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,862.09 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,380.38 / $2,754.23
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $831.76 / $4,897.79
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,174.90 / $1,659.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $870.96 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,258.93 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $588.84
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,412.54 / $1,949.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,348.96 / $1,995.26
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $6,025.60 / $8,912.51
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$602.56 / $602.56 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $2,951.21 / $4,365.16
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,949.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $2,818.38 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $7,585.78 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $1,148.15 / $2,691.53