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Vermont 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
Professional
Modifier
Low / Median / High Price
$698.50 / $698.50 / $1,624.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,047.74 / $7,047.74 / $7,047.74
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,047.74 / $7,047.74 / $7,047.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.12 / $2,932.34 / $8,524.53