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Maryland rates for HCPCS 0481T

Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.97 / $268.87 / $287.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.55 / $376.10 / $608.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.99 / $336.69 / $598.96