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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,470.53 / $4,387.00 / $9,078.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,748.34 / $35,335.00 / $51,493.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $9,753.00 / $15,824.00