go back

Minnesota 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
$800.06 / $800.06 / $800.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.66 / $701.58 / $825.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.52 / $3,057.02 / $6,480.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.10 / $372.62 / $372.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.64 / $693.97 / $1,669.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.02 / $217.88 / $276.70
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.32 / $633.29 / $1,314.51
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.75 / $172.38 / $217.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.35 / $364.34 / $1,352.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.65 / $425.85 / $1,438.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.71 / $518.83 / $1,049.97