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Nebraska 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 $4,074 · 10th–90th $135–$12,5890%10%10th90th$4,074Professionalmedian $74 · 10th–90th $63–$1660%20%10th90th$74$50.0$200.0$1.0K$5.0K$20.0K

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
$2,187.76 / $6,025.60 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $67.61 / $74.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $8,709.64 / $16,982.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $316.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $316.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $138.04 / $204.17