go back

Mississippi 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
$494.64 / $494.64 / $815.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.98 / $534.75 / $825.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.66 / $43.66 / $43.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.12 / $173.52 / $335.37