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Montana rates for HCPCS 22612

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

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,512.80 / $2,512.80 / $2,512.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,239.09 / $1,703.77 / $2,512.80