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Arizona rates for HCPCS 0717T

Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing and concentration of ADRCs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $3,890.45 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,090.30 / $4,786.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $1,348.96 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $104.71 / $190.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $4,897.79 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $4,073.80 / $7,244.36