go back

Ohio 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
$2,454.71 / $6,760.83 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $6,918.31 / $11,748.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,548.13 / $15,135.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $489.78 / $758.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,686.94 / $41,686.94 / $63,095.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75,857.76 / $75,857.76 / $75,857.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $50.12 / $60.26
SummaCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $60.26 / $75.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $5,754.40 / $9,120.11