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Kentucky 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
$407.58 / $448.79 / $689.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.75 / $448.79 / $919.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.24 / $127.65 / $199.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.00 / $121.00 / $121.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.98 / $818.96 / $942.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $361.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.89 / $827.90 / $1,226.47