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Nationwide rates for HCPCS 22867

Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $5,370.32 / $12,589.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $12,022.64 / $28,840.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,884.03 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$181.97 / $181.97 / $181.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $9,120.11 / $21,877.62