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Louisiana 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
$933.25 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,905.46 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $9,549.93 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $3,548.13 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,949.84 / $4,265.80