| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $381.21 | $381.21 | $381.21 | |
Providence
| Facility | $187.15 | $204.89 | $381.21 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $381.21 | $381.21 | $381.21 | |
Providence
| Facility | $187.15 | $204.89 | $381.21 |