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Arkansas 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
$676.08 / $676.08 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $691.83 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $3,235.94 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $851.14 / $1,174.90