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Massachusetts 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

Facilitymedian $2,884 · 10th–90th $513–$5,8880%10%10th90th$2,884$100.0$500.0$2.0K$10.0K$50.0K

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
$1,513.56 / $2,884.03 / $5,128.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,888.44 / $20,892.96
AllWays Health Partners
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $6,309.57
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $575.44 / $3,630.78
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $6,918.31 / $15,488.17
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,888.44 / $20,892.96
Mass General Brigham
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $6,309.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $6,165.95 / $20,892.96