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Texas 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
$831.76 / $3,630.78 / $12,022.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $5,128.61 / $13,803.84
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $114.82 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $6,918.31 / $6,918.31
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $4,073.80
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$83.18 / $83.18 / $83.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $208.93 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $186.21 / $316.23
Providence
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$22.91 / $22.91 / $22.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $1,047.13 / $2,691.53