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Indiana 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
$1,380.38 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,380.38 / $4,677.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $14,454.40 / $19,498.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $398.11 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $52,480.75 / $66,069.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $8,317.64 / $11,481.54