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Kansas 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
$627.52 / $627.52 / $627.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.52 / $762.26 / $851.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.52 / $762.87 / $1,111.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.31 / $240.27 / $4,977.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.30 / $211.64 / $497.69