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Idaho 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
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,344.23 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $6,760.83 / $18,620.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $1,737.80 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,495.41
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,344.23 / $3,235.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,454.71 / $8,128.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $16,218.10 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $3,162.28 / $4,168.69
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $18,620.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $9,332.54 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $1,230.27 / $2,951.21