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Utah 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
$3,162.28 / $10,964.78 / $26,915.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $23,988.33 / $93,325.43
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,019.95 / $4,365.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $5,128.61 / $32,359.37