go back

South Dakota rates for HCPCS 22870

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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $2,290.87 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $194.98 / $269.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $295.12 / $295.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $199.53 / $251.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83