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South Dakota rates for HCPCS 0629T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level

Facilitymedian $407 · 10th–90th $240–$4,3650%20%10th90th$407Professionalmedian $240 · 10th–90th $234–$3310%20%40%10th90th$240$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
$239.88 / $2,290.87 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $239.88 / $263.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $407.38 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $1,819.70
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $331.13 / $724.44