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Arizona rates for HCPCS 22869

Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.00 / $2,933.00 / $6,483.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,640.00 / $10,860.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$412.34 / $578.72 / $9,251.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$112.50 / $112.50 / $5,848.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,255.00 / $7,205.00 / $11,396.00