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Maryland 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
Professional
Modifier
Low / Median / High Price
$660.69 / $1,778.28 / $2,290.87
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,089.30 / $3,981.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $851.14 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $2,187.76 / $5,128.61