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Wisconsin 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
$54.95 / $54.95 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $87.10 / $144.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,584.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $125.89 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $302.00 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $154.88 / $177.83
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $91.20 / $199.53
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $199.53 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $158.49 / $676.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $218.78 / $309.03
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $234.42 / $562.34
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $436.52 / $660.69
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $616.60 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $141.25 / $398.11