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Virginia 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
$1,549.42 / $5,412.00 / $13,209.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,142.00 / $37,782.72 / $52,623.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $1,551.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.83 / $1,670.18 / $1,964.35
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,126.85 / $1,549.42 / $2,487.46
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,281.81 / $1,849.28 / $9,563.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,408.00 / $13,296.00 / $26,537.00