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Connecticut rates for HCPCS G0460

Autologous Platelet Rich Plasma Or Other Blood-Derived Product For Non-Diabetic Chronic Wounds/Ulcers Including As Applicable Phlebotomy Centrifugation Or Mixing And All Other Preparatory Procedures Administration And Dressings Per Treatment (Desc Rvsd 7/1/23)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.14 / $110.14 / $110.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.66 / $210.02 / $894.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.08 / $425.00 / $562.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.50 / $370.67 / $656.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.03 / $269.48 / $1,780.83