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Nebraska 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
$1,506.15 / $5,463.36 / $13,841.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,766.83 / $15,476.59 / $29,936.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.48 / $364.78 / $3,156.58
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$57.75 / $109.91 / $109.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.35 / $528.39 / $748.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00