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Indiana 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
$408.00 / $2,318.00 / $7,212.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,497.00 / $26,400.00 / $56,650.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$396.27 / $515.15 / $594.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,577.74 / $14,577.74 / $17,280.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.00 / $12,330.00 / $17,416.00