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Nationwide rates for HCPCS G0465

Autologous platelet rich plasma (PRP) or other blood-derived product for diabetic chronic wounds/ulcers, using an FDA-cleared device for this indication, (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
$491.99 / $633.62 / $819.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.77 / $701.43 / $896.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.49 / $198.87 / $523.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.47 / $234.21 / $890.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.00 / $121.00 / $121.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.96 / $818.96 / $818.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.02 / $930.89 / $1,456.70