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Wisconsin 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 $589 · 10th–90th $110$3,8900%10%10th90th$589Professionalmedian $794 · 10th–90th $182$2,5120%5%10%10th90th$794$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $630.96 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,258.93 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,951.21 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $977.24 / $1,621.81
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $478.63 / $2,454.71
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $478.63 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,202.26 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $1,174.90 / $3,467.37
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $5,011.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $5,011.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $1,071.52
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,096.48 / $2,630.27