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Minnesota 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 $95 · 10th–90th $71–$2,5700%20%10th90th$95Professionalmedian $74 · 10th–90th $50–$1320%20%10th90th$74$1.0$5.0$20.0$100.0$500.0$2.0K

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
$72.44 / $72.44 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $588.84 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $354.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $123.03 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $141.25 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,862.09 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $114.82 / $245.47