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Maryland 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
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,187.76 / $2,951.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,000.00 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,290.87 / $3,467.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $851.14 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $1,548.82 / $3,388.44