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Indiana 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
$1,380.38 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,862.09 / $2,951.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $30,199.52 / $43,651.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $501.19 / $891.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $29,512.09 / $44,668.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $6,165.95 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $9,120.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,762.47 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $1,174.90 / $2,511.89