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Hawaii 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
Professional
Modifier
Low / Median / High Price
$66.36 / $117.02 / $748.21
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
$74.14 / $141.22 / $183.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.84 / $215.28 / $355.06