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Oregon 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 $145 · 10th–90th $87–$6,6070%20%40%10th90th$145Professionalmedian $76 · 10th–90th $58–$1550%20%10th90th$76$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
$87.10 / $6,606.93 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $95.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $190.55
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $147.91
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $93.33
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $144.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $144.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $154.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $151.36 / $204.17