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Tennessee 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
$750.00 / $2,311.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,430.00 / $7,178.00 / $13,961.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $61,697.35 / $61,697.35
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$112.50 / $5,848.03 / $5,848.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,098.00 / $8,273.00 / $12,407.00