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Washington 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
$2,818.38 / $15,488.17 / $58,884.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $758.58 / $870.96
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $3,715.35 / $45,708.82
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,467.37 / $3,630.78
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $7,762.47
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,686.94 / $52,480.75 / $100,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $79,432.82 / $154,881.66