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Wisconsin 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 $933 · 10th–90th $224–$6,9180%5%10th90th$933Professionalmedian $513 · 10th–90th $331–$7590%10%20%10th90th$513$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$218.78 / $457.09 / $14,454.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $1,071.52
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $512.86 / $10,471.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $512.86 / $1,778.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $512.86 / $758.58
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $3,801.89
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$57.54 / $57.54 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76