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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
$84.00 / $150.18 / $150.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.13 / $247.97 / $247.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.56 / $235.11 / $360.68
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.00 / $150.18 / $150.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.08 / $249.42 / $324.85