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Massachusetts 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 / $1,886.00 / $3,625.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $165.59
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.00 / $1,600.00 / $4,142.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.38 / $290.20 / $411.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.42 / $123.90 / $245.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.79 / $122.50 / $122.50
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $3,472.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.52 / $226.82 / $470.65
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,234.83 / $1,378.44 / $2,049.38
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.00 / $1,930.00 / $7,161.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $2,408.00 / $5,683.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.99 / $202.96 / $428.03