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Maine 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
$660.87 / $660.87 / $660.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $127.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.39 / $437.95 / $437.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.05 / $202.80 / $325.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.87 / $660.87 / $660.87
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $1,965.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.23 / $119.23 / $182.90