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Pennsylvania rates for HCPCS 22634

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; each additional interspace (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$687.36 / $2,505.00 / $6,432.00
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
$550.42 / $550.42 / $550.42
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$337.64 / $337.64 / $337.64
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$54.02 / $54.02 / $54.02
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,402.58 / $9,402.58 / $9,402.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$687.36 / $2,667.00 / $7,197.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.42 / $550.42 / $550.42
Priority Health
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$337.64 / $337.64 / $337.64
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$54.02 / $54.02 / $54.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.58 / $471.70 / $471.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.00 / $650.00 / $3,742.00