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North Dakota 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
$103.17 / $103.17 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.17 / $103.17 / $157.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.17 / $103.17 / $309.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.15 / $292.16 / $381.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.44 / $311.18 / $381.18