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South Dakota 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)

Facilitymedian $759 · 10th–90th $447–$4,3650%20%10th90th$759Professionalmedian $794 · 10th–90th $191–$1,0230%10%20%10th90th$794$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $2,290.87 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $1,096.48
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,096.48 / $1,096.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $870.96 / $933.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83