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Washington, DC rates for HCPCS G0460

Autologous platelet rich plasma (PRP) or other blood-derived product for nondiabetic chronic wounds/ulcers (includes, as applicable: administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$896.54 / $896.54 / $896.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.93 / $896.54 / $896.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.00 / $1,410.00 / $4,500.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.97 / $630.72 / $630.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.58 / $229.03 / $1,820.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.42 / $201.29 / $2,115.27