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West Virginia rates for HCPCS 0629T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.59 / $250.59 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.27 / $275.14 / $321.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.23 / $3,911.06 / $7,730.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119,998.80 / $119,998.80 / $119,998.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.02 / $283.02 / $283.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,178.68 / $1,178.68 / $1,178.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.85 / $332.72 / $473.43