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Mississippi 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
$494.64 / $494.64 / $815.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.43 / $534.75 / $815.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.66 / $43.66 / $43.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.96 / $818.96 / $818.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.32 / $797.90 / $1,184.06