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Illinois 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
$1,148.15 / $3,235.94 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,778.28 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $10,471.29 / $12,589.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $323.59 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $6,760.83 / $6,760.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,951.21
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $2,754.23 / $3,630.78
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $5,495.41 / $9,772.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,862.09 / $4,265.80