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Idaho rates for HCPCS 0264T

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $173.78 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $4,897.79 / $12,022.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $346.74 / $363.08
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $186.21 / $4,466.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $173.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,762.47 / $10,471.29 / $14,454.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $245.47 / $269.15
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,585.78 / $10,964.78 / $12,302.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $22,387.21 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $213.80 / $316.23