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North Carolina 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
$1,659.59 / $6,165.95 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,905.46 / $2,290.87
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $1,862.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $5,754.40 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,949.84 / $5,128.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $9,332.54 / $11,481.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $2,238.72 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $9,332.54 / $14,454.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,290.87 / $4,265.80
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,952.62 / $19,952.62 / $19,952.62
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,454.40 / $15,848.93 / $15,848.93