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Utah 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 $3,388 · 10th–90th $2,239–$6,0260%20%10th90th$3,388Professionalmedian $251 · 10th–90th $224–$3800%20%10th90th$251$50.0$200.0$1.0K$5.0K$20.0K

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
$251.19 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $245.47 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $25,118.86 / $38,904.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $302.00 / $501.19
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $288.40
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $316.23 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $457.09