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Utah 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 $6,026 · 10th–90th $3,162–$11,2200%10%10th90th$6,026Professionalmedian $1,660 · 10th–90th $1,148–$2,5120%20%10th90th$1,660$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
$1,479.11 / $6,025.60 / $9,332.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $36,307.81 / $54,954.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $35,481.34