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Wisconsin 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
$1,680.19 / $6,303.76 / $41,848.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,080.00 / $17,505.00 / $23,937.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,732.71 / $2,079.25 / $2,673.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,439.82 / $5,188.28 / $7,958.95
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,680.19 / $2,358.02 / $3,833.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,711.27 / $3,537.02 / $22,275.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,680.19 / $2,358.02 / $3,833.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,578.90 / $4,360.75 / $6,509.74
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,824.49 / $18,824.49 / $18,824.49
Quartz
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$5,209.43 / $5,209.43 / $5,209.43
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$833.51 / $833.51 / $833.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,147.00 / $15,618.00 / $23,474.00