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Michigan rates for HCPCS 0217T

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $89.13 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $120.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $2,041.74 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $93.33 / $134.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $1,202.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $102.33 / $141.25