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Texas 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 $2,188 · 10th–90th $224–$6,9180%5%10th90th$2,188Professionalmedian $76 · 10th–90th $58–$1580%20%10th90th$76$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
$630.96 / $2,511.89 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $74.13 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $645.65
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $467.74 / $4,365.16
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $95.50
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $87.10 / $154.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $954.99 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $134.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $75.86 / $75.86