go back

Wisconsin rates for HCPCS G0259

Injection procedure for sacroiliac joint; arthrography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $125.89 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $125.89 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,584.89 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $169.82 / $169.82
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $125.89 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $125.89 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,949.84