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Oklahoma 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 $1,660 · 10th–90th $100–$6,6070%5%10%10th90th$1,660Professionalmedian $74 · 10th–90th $54–$980%20%10th90th$74$50.0$200.0$1.0K$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
$758.58 / $2,454.71 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $87.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $123.03 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $602.56 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $81.28 / $112.20