go back

Missouri 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
$1,098.00 / $4,261.00 / $12,174.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $6,000.00 / $13,384.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.65 / $712.25 / $9,475.00
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
$2,209.00 / $5,717.00 / $12,989.00