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Hawaii 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
$2,818.38 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,570.40 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $478.63 / $676.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,398.83 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $1,348.96 / $2,884.03