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Georgia 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
$691.83 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $1,000.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $74.13 / $1,995.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $776.25 / $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
$85.11 / $93.33 / $1,071.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $1,000.00 / $1,905.46