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West Virginia rates for HCPCS 28304

Osteotomy, tarsal bones, other than calcaneus or talus;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$598.48 / $937.73 / $1,400.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.78 / $726.20 / $791.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.54 / $1,051.54 / $1,051.54
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$105.15 / $105.15 / $105.15