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Minnesota 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
$45.89 / $127.09 / $1,983.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $127.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.74 / $1,509.51 / $2,457.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.12 / $126.51 / $126.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.36 / $473.00 / $1,137.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.99 / $174.24 / $188.60
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$303.06 / $432.43 / $895.95
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.50 / $148.50 / $158.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.89 / $127.09 / $2,872.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,061.88 / $2,061.88 / $2,061.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,187.00 / $2,872.00 / $4,241.00