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Wisconsin rates for HCPCS 22515

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $3,019.95 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $2,344.23 / $5,623.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $588.84 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $9,332.54 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $1,380.38 / $14,125.38
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $3,715.35 / $9,332.54
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $741.31 / $7,585.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,445.44 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $7,762.47 / $31,622.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $3,311.31 / $9,772.37
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $18,197.01
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $7,762.47 / $31,622.78
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $12,022.64 / $18,620.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $2,818.38 / $13,182.57