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New Mexico 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 $2,089 · 10th–90th $78–$7,7620%20%10th90th$2,089Professionalmedian $79 · 10th–90th $50–$1150%20%10th90th$79$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
$1,047.13 / $2,137.96 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $75.86 / $95.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $85.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,148.15 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $162.18