go back

Indiana rates for HCPCS G0415

Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,265.33 / $1,494.00 / $10,985.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,800.00 / $33,765.49 / $49,433.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,231.91 / $1,601.48 / $1,847.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.00 / $12,330.00 / $17,416.00