go back

Nebraska 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
$4,917.20 / $9,248.33 / $19,276.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,042.00 / $1,489.86 / $11,100.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.62 / $491.41 / $950.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,936.00 / $2,936.00 / $2,936.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,936.00 / $3,425.33 / $4,599.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00