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South Dakota 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 $724 · 10th–90th $437–$4,3650%20%10th90th$724Professionalmedian $708 · 10th–90th $174–$9550%10%20%10th90th$708$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$436.52 / $3,090.30 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $707.95 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,071.52 / $1,071.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $741.31 / $933.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $26,302.68