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Wisconsin 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)

Facilitymedian $933 · 10th–90th $115–$6,9180%5%10%10th90th$933Professionalmedian $240 · 10th–90th $155–$3720%10%20%10th90th$240$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$114.82 / $239.88 / $14,454.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $354.81 / $562.34
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $269.15 / $10,471.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $269.15 / $1,778.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $371.54
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $1,862.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76