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North Dakota 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
$123.41 / $123.41 / $210.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.41 / $709.74 / $800.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.53 / $292.26 / $462.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.75 / $217.88 / $630.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.14 / $210.02 / $707.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.30 / $128.26 / $498.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.64 / $303.66 / $979.48