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Wisconsin rates for HCPCS 22558

Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,431.43 / $5,355.64 / $71,564.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $8,006.00 / $18,294.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,457.51 / $1,749.01 / $2,241.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,774.79 / $4,411.14 / $6,766.81
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,431.43 / $2,147.15 / $3,410.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,438.77 / $3,005.03 / $19,754.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,431.43 / $2,147.15 / $3,410.09
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,009.50 / $3,666.96 / $5,474.05
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,905.79 / $15,905.79 / $15,905.79
Quartz
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$4,380.60 / $4,380.60 / $4,380.60
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$700.90 / $700.90 / $700.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,650.00 / $15,355.00 / $27,414.00