go back

Idaho 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
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $2,089.30 / $2,630.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $6,760.83 / $18,620.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $1,122.02 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $4,168.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $2,187.76 / $3,235.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,398.83 / $6,456.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $16,218.10 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,162.28 / $4,365.16
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $1,318.26 / $13,489.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $9,332.54 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,737.80 / $4,073.80