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California 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
$2,421.00 / $8,870.00 / $19,368.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,314.00 / $10,474.00 / $20,369.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $6,806.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,469.00 / $27,672.72 / $49,563.08
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.54 / $1,184.57 / $19,756.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.32 / $1,347.66 / $2,443.26
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $8,987.58 / $79,924.50
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$234.05 / $7,575.71 / $7,575.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,066.82 / $1,323.53 / $1,819.85
Providence
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$121.06 / $121.06 / $348.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,212.00 / $13,722.00 / $29,312.00