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South Dakota rates for HCPCS 22853

Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)

Facilitymedian $575 · 10th–90th $240–$4,3650%10%20%10th90th$575Professionalmedian $355 · 10th–90th $30–$7760%10%10th90th$355$20.0$100.0$500.0$2.0K$10.0K

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
$239.88 / $1,148.15 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $562.34 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$16.22 / $64.57 / $100.00
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $275.42 / $478.63
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $501.19 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $549.54 / $676.08
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $398.11 / $812.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $457.09 / $1,819.70
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $575.44 / $575.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $549.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $436.52 / $549.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
80
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $416.87 / $676.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $602.56 / $602.56