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Mississippi 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
$70.64 / $936.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.26 / $63.00 / $89.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.50 / $42.50 / $50.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $513.00 / $1,739.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.63 / $104.04 / $199.65