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Tennessee 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
$707.95 / $2,454.71 / $6,456.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $151.36 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,073.80 / $4,073.80
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$83.18 / $83.18 / $83.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $812.83 / $2,511.89