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Alaska rates for HCPCS 0628T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separately in addition to code for primary procedure)

Facilitymedian $95 · 10th–90th $59–$9,7720%20%10th90th$95Professionalmedian $76 · 10th–90th $69–$2040%20%40%10th90th$76$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $6,606.93 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $74.13 / $87.10
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $134.90
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $75.86 / $93.33
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $309.03 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $204.17 / $512.86