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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
$489.78 / $489.78 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $512.86 / $812.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $44.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $3,715.35 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $812.83 / $1,148.15