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Lumbar Spine Fusion From the Back, One Level

Wisconsin rates for HCPCS 22612

Fusion of one level of the lower spine through an incision in the back, where the surfaces of two neighboring vertebrae are prepared and bone graft is packed along them so they knit into one solid block. It is done for instability, slippage of one vertebra on another, or ongoing pain from a worn-out level. Further levels fused in the same operation are billed separately, as are any rods and screws used.

Rates data updated July 2026.

Facilitymedian $15,136 · 10th–90th $2,455$28,8400%10%20%10th90th$15,136Professionalmedian $3,631 · 10th–90th $2,399$5,1290%20%10th90th$3,631$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.81
Median
$1,479.11
Typical High
$20,892.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$16,982.44
Typical High
$30,199.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$4,570.88
Typical High
$8,128.31
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,235.94
Typical High
$10,471.29
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,467.37
Typical High
$16,595.87
Network Health
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$10,715.19
Typical High
$17,378.01
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$2,089.30
Typical High
$3,548.13
Quartz
Setting
Professional
Modifier
Global
Typical Low
$2,398.83
Median
$3,548.13
Typical High
$5,128.61
Quartz
Setting
Facility
Modifier
Global
Typical Low
$28,840.32
Median
$52,480.75
Typical High
$75,857.76
Quartz
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$33,113.11
Median
$33,113.11
Typical High
$47,863.01
Quartz
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$7,585.78
Security Health
Setting
Professional
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$4,897.79
United
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$13,803.84
Typical High
$17,782.79