go back

Virginia 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
$3,226.00 / $5,412.00 / $8,925.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.00 / $3,226.00 / $6,827.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,032.00 / $6,548.00 / $7,221.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $413.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $640.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,121.00 / $9,270.00 / $17,192.00