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Oklahoma 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
$882.00 / $3,683.00 / $7,500.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.07 / $319.23 / $2,562.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$57.75 / $109.91 / $109.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $610.00 / $1,883.00