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Maine 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
$83.18 / $151.36 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $245.47 / $275.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $346.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $151.36 / $173.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $229.09 / $363.08