go back

Minnesota 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
$1,905.46 / $1,905.46 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,778.28 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $15,488.17 / $32,359.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,548.82 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $7,413.10 / $17,782.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,454.71 / $2,818.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $7,079.46 / $13,803.84
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $3,090.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $3,311.31 / $9,332.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $2,951.21 / $11,481.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $5,495.41 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $2,454.71 / $6,606.93