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Indiana rates for HCPCS 0630T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.17 / $3,500.00 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.78 / $56.37 / $79.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.56 / $97.56 / $188.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.92 / $184.76 / $263.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.02 / $1,140.35 / $1,810.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.42 / $70.42 / $100.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.12 / $304.85 / $304.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.19 / $87.46 / $149.87