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Virginia 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
$177.83 / $4,365.16 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $158.49 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $263.03 / $380.19
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $912.01 / $5,248.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $190.55 / $234.42
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $181.97 / $302.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $190.55 / $309.03
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $190.55 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $11,481.54 / $23,988.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $186.21 / $316.23