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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)  (Desc Rvsd 7/1/23)

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