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Montana rates for HCPCS 0627T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level

Facilitymedian $479 · 10th–90th $389–$5010%50%10th90th$479Professionalmedian $263 · 10th–90th $182–$4790%20%10th90th$263$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $263.03 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $398.11 / $446.68
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $489.78 / $501.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $489.78 / $501.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $323.59 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $398.11 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $436.52 / $501.19