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Utah rates for HCPCS 0263T

Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure including unilateral or bilateral bone marrow harvest

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $61.66 / $131.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $44.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $7,943.28 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $87.10 / $489.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.20
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $77.62 / $91.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $54.95 / $117.49