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Washington 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 $1,288 · 10th–90th $617–$28,1840%5%10th90th$1,288$500.0$2.0K$10.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $6,025.60 / $18,620.87
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,183.83 / $37,153.52 / $70,794.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $30,902.95
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $954.99 / $26,302.68
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $851.14 / $1,047.13
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $588.84 / $7,585.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,915.35 / $37,153.52 / $70,794.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $37,153.52 / $72,443.60