Based on Level 1 evidence in orthopedics, how much should a clinic charge for a PRP injection for knee osteoarthritis? We already know that PRP has been shown to work better and last longer than steroid or hyaluronic acid injections….that is a fact based on over 25 level 1 studies from around the world. Since PRP is not covered for knee arthritis in the USA, what should the doctor charge the patient?
A level 1 paper published in 2020 evaluated this question and determined that for an insurance company payor… PRP total cost (office visit, procedure, injectable supplies and product) should be less than $1192.08 per year to be cost effective compared to hyaluronic acid.
What a clinic charges is set at the visit. What matters more is the dose, how many injections it takes to get there, and the outcome at the end. Three low dose injections and one high dose injection are not the same purchase, and a number for a single injection tells you nothing about which one you are being offered.
Common questions
- How much should a PRP injection for knee arthritis cost?
- A level 1 paper published in 2020 concluded that total PRP cost, covering the office visit, the procedure, injectable supplies and the product, should come in under $1192.08 per year to be cost effective for an insurance payor compared with hyaluronic acid. That figure assumed nothing about platelet dose, how many injections were needed, or the outcome at the end of them. PRP for knee arthritis is not covered by insurance in the USA.
- Does PRP work better than a steroid or gel injection for knee arthritis?
- Yes, and it lasts longer. That conclusion rests on more than 25 level 1 studies from around the world comparing PRP with steroid and hyaluronic acid injections for knee osteoarthritis. Level 1 is the strongest study design in orthopedics, which is why the 2020 cost-effectiveness paper used hyaluronic acid as its comparison rather than asking whether PRP works at all.
- Why is PRP not covered by insurance if the evidence is that strong?
- Coverage follows payor policy, not published evidence alone. PRP is not covered for knee arthritis in the USA today, which is exactly why the 2020 level 1 paper asked what an insurance payor should be willing to pay and arrived at $1192.08 per year against hyaluronic acid. Until policy changes, patients pay directly and should ask what platelet dose they are getting for it.
