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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
$501.19 / $2,290.87 / $4,073.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $151.36 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $3,801.89 / $3,801.89
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$380.19 / $380.19 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $812.83 / $2,511.89