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Hawaii 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
$1,513.56 / $3,890.45 / $3,890.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $489.78 / $602.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95