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Michigan 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
$1,949.84 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,949.84 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $6,606.93 / $7,079.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,454.71
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,818.38 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,778.28 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $6,456.54 / $14,454.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $676.08 / $1,995.26