go back

Pennsylvania rates for HCPCS 0215T

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $97.72 / $112.20
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $100.00 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $165.96 / $316.23
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,265.80 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $97.72 / $112.20
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $69.18 / $100.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $100.00 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $676.08 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $114.82 / $177.83