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Maryland 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
Professional
Modifier
Low / Median / High Price
$154.72 / $167.82 / $179.44
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.00 / $766.00 / $766.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,652.37 / $2,652.37 / $2,652.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.33 / $221.02 / $369.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.32 / $180.38 / $320.49