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New York rates for HCPCS 20931

Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $3,090.30 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,786.30 / $10,232.93
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $46,773.51 / $56,234.13
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $177.83 / $707.95
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,819.70 / $2,691.53
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,754.23 / $4,897.79
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $181.97 / $549.54