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Michigan 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
$548.14 / $2,877.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,604.79 / $28,878.79 / $39,126.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.03 / $2,877.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,635.00 / $10,192.00 / $12,767.00