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Virginia 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
$158.49 / $4,897.79 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $138.04 / $162.18
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $263.03 / $323.59
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $186.21 / $288.40
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $186.21 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $1,202.26 / $2,454.71