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Idaho 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 $1,413 · 10th–90th $74–$5,4950%10%20%10th90th$1,413Professionalmedian $76 · 10th–90th $68–$1120%20%10th90th$76$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
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $117.49
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $85.11 / $190.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $79.43 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $144.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $85.11 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $1,819.70 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $158.49