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Wisconsin 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 $16,982 · 10th–90th $1,585–$28,8400%10%10th90th$16,982Professionalmedian $955 · 10th–90th $631–$1,4450%10%20%10th90th$955$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $891.25 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $18,620.87 / $30,902.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $2,238.72
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $1,000.00 / $10,471.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,122.02 / $16,595.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,715.19 / $17,378.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $1,445.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $41,686.94 / $61,659.50
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $6,165.95
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,125.38 / $18,197.01