go back

Nebraska 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
$7,244.36 / $8,511.38 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,819.70 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $8,709.64 / $16,982.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $1,548.82 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,754.23 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $3,162.28 / $10,471.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $2,691.53 / $5,754.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,951.21 / $4,466.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,495.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,890.45 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $6,606.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,691.53 / $5,128.61