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Michigan 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
$1,949.84 / $4,897.79 / $40,738.03
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
$6,606.93 / $6,606.93 / $6,606.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $6,606.93 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,454.71
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $3,801.89 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,778.28 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $6,456.54 / $14,454.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $933.25 / $2,630.27