go back

Pennsylvania rates for HCPCS 22858

Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $2,691.53 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$87.10 / $87.10 / $87.10
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $9,772.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $2,344.23 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $1,000.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $676.08 / $4,265.80