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Iowa 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 $2,291 · 10th–90th $69–$6,4570%10%10th90th$2,291Professionalmedian $78 · 10th–90th $54–$1230%10%20%10th90th$78$50.0$200.0$1.0K$5.0K

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
$67.61 / $2,570.40 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $169.82
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $114.82 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $123.03 / $549.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $218.78