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Maine rates for HCPCS 0490T

Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.54 / $605.54 / $605.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.85 / $58.58 / $73.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.31 / $822.27 / $1,218.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.54 / $605.54 / $605.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.55 / $867.84 / $1,155.47