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Louisiana rates for HCPCS G0260

Injection Procedure For Sacroiliac Joint; Provision Of Anesthetic Steroid And/Or Other Therapeutic Agent With Or Without Arthrography. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.09 / $1,300.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $127.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$678.74 / $1,373.07 / $2,723.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$437.65 / $437.65 / $437.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.00 / $1,086.00 / $2,755.00