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Utah 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
$802.28 / $3,084.00 / $4,707.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,314.50 / $25,330.44 / $36,365.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $9,753.00 / $15,824.00