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New York 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 $5,888 · 10th–90th $832–$14,4540%10%10th90th$5,888$50.0$200.0$1.0K$5.0K$20.0K

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
$776.25 / $3,801.89 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $11,481.54 / $26,302.68
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $2,630.27 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $724.44 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $630.96 / $1,513.56
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $6,309.57 / $16,982.44
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $741.31 / $1,023.29