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Connecticut 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
$3,235.94 / $4,677.35 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $75.86 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $251.19 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $3,467.37 / $6,760.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $120.23 / $223.87