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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
$407.38 / $407.38 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $630.96 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $147.91 / $199.53
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 / $4,265.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $812.83 / $1,412.54