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Indiana rates for HCPCS 0275T

Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,705.10 / $16,700.00 / $33,821.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$890.42 / $1,362.24 / $1,879.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.00 / $14,850.00 / $65,624.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.09 / $1,095.38 / $1,891.98