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Idaho rates for HCPCS 0489T

Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting, isolation and preparation of harvested cells including incubation with cell dissociation enzymes, removal of non-viable cells and debris, determination of concentration and dilution of regenerative cells

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $213.80 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $275.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $173.78 / $4,466.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $190.55 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $380.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $275.42 / $354.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $15,488.17 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $263.03 / $331.13