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Nevada 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
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $691.83 / $891.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $74.13 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $169.82 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $1,174.90 / $1,778.28
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $1,584.89 / $1,584.89
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $977.24 / $1,380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $912.01 / $1,445.44