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Hawaii rates for HCPCS 22868

Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$988.00 / $2,747.00 / $2,898.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.24 / $271.89 / $317.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,078.00 / $1,078.00