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Massachusetts rates for HCPCS 22103

Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $3,311.31 / $5,128.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $1,862.09 / $3,467.37
AllWays Health Partners
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$83.18 / $83.18 / $83.18
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $575.44 / $7,079.46
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,041.74 / $3,467.37
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $1,862.09 / $3,467.37
Mass General Brigham
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$83.18 / $83.18 / $83.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,862.09 / $2,818.38