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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,778.28 / $3,090.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $10,000.00 / $15,488.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,698.24 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $5,128.61 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,862.09 / $3,890.45