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Indiana 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
$331.13 / $3,801.89 / $5,623.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $436.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $229.09 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $316.23 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,238.72 / $7,413.10