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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $162.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $8,128.31 / $10,715.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $213.80 / $338.84