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Pennsylvania 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)

Facilitymedian $891 · 10th–90th $891$6,6070%50%90th$891Professionalmedian $708 · 10th–90th $447$9330%10%10th90th$708$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$676.08
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,659.59
Typical High
$1,819.70
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,122.02
Typical High
$1,445.44
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$2,398.83
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$676.08
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$6,025.60
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$831.76
Typical High
$1,548.82