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Michigan 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
$2,041.74 / $2,041.74 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $2,041.74 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $1,258.93 / $2,041.74