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West 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
$1,400.00 / $1,400.00 / $1,700.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119,998.80 / $119,998.80 / $119,998.80