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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,089.30 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $10,000.00 / $15,488.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,698.24 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $5,128.61 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,412.54 / $3,162.28