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Pennsylvania rates for HCPCS 0164T

Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (List separately in addition to code for primary procedure)

Facilitymedian $2,692 · 10th–90th $912–$8,3180%5%10th90th$2,692Professionalmedian $851 · 10th–90th $525–$6,1660%10%10th90th$851$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
$912.01 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $851.14 / $13,489.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $3,311.31
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $831.76 / $7,244.36
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,096.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,096.48 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $660.69 / $1,445.44