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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $3,801.89 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $11,481.54 / $26,302.68
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,630.27 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $724.44 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$72.44 / $72.44 / $72.44
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $630.96 / $1,513.56
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $407.38
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,606.93 / $19,498.45
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $741.31 / $1,023.29