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California 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 $7,413 · 10th–90th $1,995–$15,8490%5%10%10th90th$7,413Professionalmedian $79 · 10th–90th $58–$5620%20%10th90th$79$50.0$200.0$1.0K$5.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,025.60 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $75.86 / $95.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $8,511.38 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $354.81 / $588.84
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $1,318.26 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $630.96 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $645.65
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $131.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $81.28 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,584.89 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $87.10 / $173.78