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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
$316.35 / $2,056.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,161.64 / $1,363.42 / $1,847.22
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.56 / $2,056.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,418.00 / $2,029.00