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Tennessee 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
$728.28 / $778.26 / $1,274.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.98 / $688.70 / $792.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.36 / $746.37 / $1,472.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$803.63 / $803.63 / $803.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.72 / $630.72 / $630.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.33 / $1,236.92 / $4,208.41
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,977.89 / $4,977.89 / $4,977.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.22 / $184.37 / $405.37