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Oklahoma 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
$1,258.93 / $2,630.27 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,187.76 / $11,481.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $7,244.36 / $14,125.38