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Montana rates for HCPCS 22633

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $2,433.19 / $27,104.94
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
$2,875.60 / $2,875.60 / $2,875.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,420.02 / $1,529.28 / $2,875.60