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Missouri 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
$1,778.28 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,621.81 / $2,454.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $1,071.52 / $7,244.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,344.23 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $2,398.83 / $6,918.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $2,398.83 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,019.95 / $5,888.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $2,137.96 / $3,801.89