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Oklahoma 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
$846.27 / $846.27 / $846.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.22 / $622.19 / $846.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.96 / $846.27 / $1,233.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.50 / $198.17 / $4,977.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.22 / $184.37 / $433.80