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Pennsylvania rates for HCPCS 63053

Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $2,691.53 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$38.90 / $38.90 / $38.90
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $2,344.23 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $380.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $223.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $676.08 / $4,466.84