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Missouri 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
$696.93 / $696.93 / $851.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.39 / $708.19 / $851.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.52 / $697.33 / $977.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.88 / $762.87 / $1,741.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.53 / $227.75 / $4,977.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.53 / $227.75 / $943.80