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Minnesota 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
$223.87 / $223.87 / $2,238.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $575.44 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$40.74 / $40.74 / $40.74
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $776.25 / $1,513.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $416.87 / $1,737.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $1,862.09 / $3,467.37