go back

Pennsylvania 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
$239.69 / $1,672.21 / $4,172.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $138.59
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,736.00 / $4,444.00 / $15,949.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.26 / $117.54 / $117.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$839.31 / $1,615.14 / $2,917.82
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.28 / $1,672.21 / $4,211.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.89 / $127.09 / $1,216.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.90 / $577.20 / $620.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$435.00 / $1,219.00 / $3,742.00