go back

Missouri 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
$851.00 / $3,158.00 / $8,485.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $6,000.00 / $13,384.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.89 / $354.00 / $3,064.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$57.75 / $57.75 / $109.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $1,218.00 / $9,475.00