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Louisiana 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
$173.78 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $154.88 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $7,762.47 / $12,022.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,128.61 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $186.21 / $309.03