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Michigan rates for HCPCS G0260

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.89 / $1,353.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $71.38 / $127.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.29 / $1,044.19 / $2,452.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.08 / $777.01 / $1,116.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.89 / $1,669.33 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $197.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $3,005.00 / $4,504.00