| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $426.58 | $812.83 | $1,513.56 | |
Cigna
| Professional | $812.83 | $812.83 | $812.83 | |
United
| Professional | $630.96 | $954.99 | $1,174.90 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $426.58 | $812.83 | $1,513.56 | |
Cigna
| Professional | $812.83 | $812.83 | $812.83 | |
United
| Professional | $630.96 | $954.99 | $1,174.90 |