go back

Maine 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
$1,288.25 / $1,905.46 / $2,630.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,995.26 / $2,398.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,884.03 / $5,495.41
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,905.46 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $1,548.82 / $3,801.89