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Maryland rates for HCPCS 28304

Osteotomy, tarsal bones, other than calcaneus or talus;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.53 / $3,919.61 / $9,882.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $453.73 / $3,314.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.81 / $1,111.73 / $1,470.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,003.00 / $1,003.00 / $2,156.00