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Alaska rates for HCPCS 0201T

Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $12,022.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,905.46 / $2,630.27
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $2,398.83 / $3,715.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,949.84 / $2,691.53
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $8,128.31 / $10,715.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $1,995.26 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $9,332.54 / $12,022.64