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North Dakota 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 $72 · 10th–90th $52–$8,5110%20%10th90th$72Professionalmedian $72 · 10th–90th $48–$950%20%10th90th$72$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$52.48 / $72.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $85.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $91.20 / $125.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $141.25 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $154.88