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Virginia 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 $3,020 · 10th–90th $468–$13,4900%5%10th90th$3,020Professionalmedian $490 · 10th–90th $389–$7590%10%20%10th90th$490$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $3,630.78 / $8,317.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,882.50 / $22,387.21 / $38,018.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $467.74 / $562.34
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $831.76
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $691.83 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $11,748.98 / $26,302.68