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Montana 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
Professional
Modifier
Low / Median / High Price
$182.28 / $182.28 / $182.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.11 / $267.11 / $267.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.69 / $227.04 / $267.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.33 / $191.25 / $267.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.69 / $267.11 / $375.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.16 / $332.77 / $360.95