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Colorado 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 $3,631 · 10th–90th $1,202–$8,7100%10%10th90th$3,631Professionalmedian $76 · 10th–90th $50–$1290%20%10th90th$76$20.0$100.0$500.0$2.0K$10.0K

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
$1,202.26 / $3,981.07 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $74.13 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $354.81
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $85.11 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,548.82 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $97.72 / $151.36