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Pennsylvania 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
$1,047.13 / $4,786.30 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $10,000.00 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$22.91 / $22.91 / $22.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $3,801.89 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $223.87 / $269.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $141.25 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $676.08 / $4,265.80