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Oregon rates for HCPCS G0276

Blinded Procedure For Lumbar Stenosis Percutaneous Image-Guided Lumbar Decompression (Pild) Or Placebo-Control Performed In An Approved Coverage With Evidence Development (Ced) Clinical Trial (Added 01/28/15)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.95 / $2,747.00 / $7,920.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.00 / $415.49 / $596.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.00 / $842.00 / $842.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.56 / $325.56 / $325.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.21 / $791.65 / $933.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.00 / $578.94 / $955.40
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.89 / $667.12 / $1,112.19
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.07 / $712.44 / $764.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.00 / $881.69 / $1,148.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.56 / $753.06 / $1,010.47
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,860.72 / $22,602.85 / $26,781.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.40 / $854.65 / $1,049.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $18,628.00 / $26,255.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.67 / $755.34 / $1,153.08