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Wisconsin 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)

Facilitymedian $1,318 · 10th–90th $46$3,4670%10%10th90th$1,318Professionalmedian $87 · 10th–90th $50$2750%10%10th90th$87$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
$44.67 / $44.67 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $72.44 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $141.25 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $323.59 / $323.59
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $1,698.24 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $912.01 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $549.54
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
$831.76 / $933.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $251.19
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $537.03 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $316.23