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Utah 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 $912 · 10th–90th $912$4,4670%50%90th$912Professionalmedian $661 · 10th–90th $339$1,0720%10%10th90th$661$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$588.84
Typical High
$933.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$3,548.13
Typical High
$5,495.41
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$660.69
Typical High
$1,096.48
Select Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$1,000.00
Typical High
$1,479.11
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$741.31
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$776.25
Typical High
$1,174.90