go back

Arizona 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 $2,188 · 10th–90th $100–$5,6230%10%10th90th$2,188Professionalmedian $74 · 10th–90th $50–$1020%20%10th90th$74$20.0$100.0$500.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $3,090.30 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $83.18 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $37.15 / $70.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $141.25 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $144.54