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Florida 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
$377.00 / $3,276.00 / $11,481.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.26 / $77.06 / $89.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.22 / $56.22 / $56.22
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,187.12 / $4,829.14 / $10,380.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.51 / $71.52 / $83.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $112.05 / $134.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.00 / $1,950.00 / $5,107.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.34 / $82.40 / $144.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.80 / $246.80 / $246.80