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Ohio 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
$621.86 / $3,325.00 / $10,635.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,969.00 / $9,153.00 / $60,320.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.85 / $414.38 / $603.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.30 / $491.30 / $491.30
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$48.50 / $48.50 / $48.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,070.00 / $8,440.00 / $13,382.00