go back

Nebraska 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
$1,653.00 / $5,463.36 / $13,841.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,828.40 / $10,296.48 / $19,916.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,316.30 / $16,316.30 / $16,316.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.67 / $726.61 / $9,696.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$112.50 / $5,848.03 / $5,848.03
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.14 / $1,082.45 / $20,667.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,777.00 / $8,220.00 / $9,696.00