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West Virginia 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
$562.34 / $7,762.47 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $575.44 / $1,023.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $562.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $1,862.09
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
$436.52 / $724.44 / $4,365.16
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $4,897.79
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $707.95 / $707.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $602.56 / $912.01