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South Dakota 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)

Facilitymedian $380 · 10th–90th $224–$4,3650%20%10th90th$380Professionalmedian $398 · 10th–90th $93–$5250%10%20%10th90th$398$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $2,290.87 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $537.03 / $537.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $512.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83