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Tennessee 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
$458.82 / $2,258.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $150.00 / $1,676.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $3,764.32 / $3,864.70
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$57.75 / $114.09 / $114.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $814.00 / $2,791.00