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Alabama 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.00 / $960.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.26 / $70.64 / $80.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,138.81 / $1,382.00 / $1,859.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.00 / $850.00 / $1,349.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.16 / $77.81 / $147.47