go back

Maine 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
$218.78 / $275.42 / $331.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $190.55 / $269.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $416.87 / $588.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $275.42 / $302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $398.11 / $616.60