| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.54 | $124.54 | $8,500.00 | |
Medica
| Facility | $124.54 | $171.47 | $211.72 |
Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.54 | $124.54 | $8,500.00 | |
Medica
| Facility | $124.54 | $171.47 | $211.72 |