| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $811.33 | $811.33 | $811.33 | |
Cigna
| Professional | $818.96 | $818.96 | $818.96 | |
United
| Professional | $579.53 | $929.81 | $1,859.62 |
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 | $811.33 | $811.33 | $811.33 | |
Cigna
| Professional | $818.96 | $818.96 | $818.96 | |
United
| Professional | $579.53 | $929.81 | $1,859.62 |