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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
$102.33 / $158.49 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $151.36 / $173.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $194.98 / $309.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $269.15 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $208.93 / $346.74