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Arizona 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
$2,041.74 / $3,890.45 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,819.70 / $2,454.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $1,348.96 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $380.19 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $2,630.27 / $6,456.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,737.80 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,570.88 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,318.26 / $3,467.37