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Arizona rates for HCPCS 0200T

Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $3,890.45 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,344.23 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $1,348.96 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $3,311.31 / $6,918.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $1,258.93 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,570.88 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $1,047.13 / $2,754.23