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Wisconsin 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 $16,982 · 10th–90th $3,467–$28,8400%10%10th90th$16,982Professionalmedian $2,399 · 10th–90th $1,585–$3,5480%10%20%10th90th$2,399$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

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
$1,000.00 / $2,089.30 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $18,620.87 / $30,902.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,090.30 / $5,248.07
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,344.23 / $10,471.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,454.71 / $16,595.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,715.19 / $17,378.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,398.83 / $3,548.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53,703.18 / $53,703.18 / $79,432.82
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $7,943.28
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,125.38 / $18,197.01