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North Dakota 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
Facility
Modifier
Low / Median / High Price
$415.12 / $415.12 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.12 / $531.46 / $538.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.12 / $539.66 / $1,245.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.89 / $1,070.67 / $1,453.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.89 / $763.93 / $1,331.11