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Pennsylvania 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
$594.00 / $2,422.00 / $7,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.06 / $155.54 / $224.20
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.00 / $2,422.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.06 / $168.37 / $1,978.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.19 / $190.19 / $190.19
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$792.02 / $792.02 / $792.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $2,391.00 / $6,322.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.58 / $203.55 / $376.80