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Pennsylvania 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

Facilitymedian $6,166 · 10th–90th $1,288–$10,4710%10%10th90th$6,166$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
$1,148.15 / $6,165.95 / $9,549.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134,896.29 / $134,896.29 / $134,896.29
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $4,786.30 / $8,709.64
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,606.93 / $56,234.13