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Iowa 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
$103.26 / $709.74 / $877.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.75 / $272.33 / $1,113.05
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.18 / $709.22 / $851.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.18 / $982.45 / $4,060.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.65 / $316.52 / $4,977.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.38 / $955.00 / $1,761.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.38 / $487.73 / $1,408.61
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.70 / $1,076.70 / $1,076.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.45 / $296.75 / $532.16
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.79 / $401.00 / $471.80