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Florida 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
$489.78 / $630.96 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $954.99 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $758.58 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,511.89 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $741.31 / $1,230.27
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $758.58