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Wisconsin 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 $16,982 · 10th–90th $4,467–$28,8400%10%10th90th$16,982Professionalmedian $288 · 10th–90th $166–$9120%10%10th90th$288$100.0$500.0$2.0K$10.0K$50.0K

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
$151.36 / $151.36 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $239.88 / $288.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,882.50 / $18,197.01 / $28,840.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24,547.09 / $24,547.09 / $24,547.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $1,230.27 / $1,230.27
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $1,698.24 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $6,165.95 / $16,595.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $457.09 / $1,819.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,715.19 / $17,378.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $588.84 / $831.76
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45,708.82 / $45,708.82 / $67,608.30
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,778.28 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,125.38 / $17,782.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $1,071.52