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Colorado 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
$100.00 / $100.00 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $676.08 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $1,096.48 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $131.83 / $1,737.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $933.25 / $1,122.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $1,047.13 / $1,778.28