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Pennsylvania rates for HCPCS 22630

Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,544.00 / $5,079.00 / $15,580.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,780.07 / $1,780.07 / $1,780.07
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$176.68 / $176.68 / $176.68
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,320.66 / $43,748.34 / $104,940.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,499.00 / $5,868.00 / $15,580.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,780.07 / $1,780.07 / $1,780.07
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$176.68 / $176.68 / $176.68
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,526.60 / $1,526.60 / $1,666.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $6,515.00 / $12,076.00