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Washington, DC 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
$870.96 / $891.25 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $741.31 / $1,071.52
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
$1,148.15 / $1,230.27 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $10,000.00 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $812.83 / $2,041.74