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South Dakota 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
$1,862.09 / $1,862.09 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,862.09 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,754.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,162.28 / $4,786.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,445.44 / $14,454.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $2,187.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,479.11 / $3,801.89