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Arkansas 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
$45.38 / $1,181.00 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.38 / $70.64 / $96.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $328.00 / $858.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.43 / $99.52 / $157.01