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Montana rates for HCPCS 0481T

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

Facilitymedian $479 · 10th–90th $355–$8910%50%10th90th$479Professionalmedian $275 · 10th–90th $186–$4790%20%40%10th90th$275$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $275.42 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $436.52
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $891.25
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $891.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $436.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $398.11 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $724.44