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Indiana rates for HCPCS 22612

Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,440.59 / $4,846.00 / $10,985.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.00 / $33,179.40 / $58,226.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,397.93 / $1,747.41 / $2,059.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,811.46 / $18,811.46 / $22,299.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,431.00 / $13,127.00 / $21,013.00