1904 - Cost and Compensation Variability in Regenerative Medicine Procedures: A National Survey

Regenerative medicine interventions such as platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and adipose-derived stem cell (ADSC) therapies are increasingly used in musculoskeletal care. However, national data on cost and provider compensation are limited, with no physiatry-specific benchmarks. Regulatory and geographic differences create uncertainty around these procedures for both clinicians and patients. This study quantifies variability in costs and compensation for seven regenerative procedures and examines how pricing relates to provider specialty, practice setting, and region.

Design:

Cross-sectional, anonymous online survey of eligible U.S. clinicians performing PRP, prolotherapy, BMAC, and ADSC procedures, conducted 11/2023–07/2025 via AAPM&R and AMSSM national conference bulletin boards, word-of-mouth, and social media outreach. Primary outcomes were patient out-of-pocket cost and provider compensation per session (USD, wRVU). Covariates: specialty, practice setting, region, image guidance, and session count. Means (SD), medians (IQR), and ranges were summarized.

Results:

220 eligible providers participated. Main specialties: Family Medicine (45.1%) and PM&R (35.6%). Procedure use: PRP 80.6%, prolotherapy 35.1%, BMAC 17%, adipose 15%. Out-of-pocket costs were right-skewed. PRP median $735 (range $210–$5000). BMAC $3,900 ($1,400–$8,000). Adipose $3600 ($1200-$8000) Prolotherapy $160 ($0–$2000).

PRP wRVU median 3.44 (range 0–9). BMAC 7.8 (0.79–16). Adipose 10 (1.1–23). Prolotherapy 1.1 (0–1.97). Costs and compensation rose with complexity (BMAC/adipose > PRP > prolotherapy) and varied by specialty/setting, with physiatrists reporting higher relative valuations for PRP compared to other specialties. Distributions were right-skewed with a wide spread, consistent with market-driven variability.

Conclusions:

Marked cost and compensation variability indicates a lack of pricing benchmarks for orthobiologics. For physiatrists, this complicates patient counseling and practice planning. These national medians provide initial reference points; future analyses will refine benchmarks by specialty and setting to support consistent, transparent pricing, and further explore cost implications for both decision-making and patient outcomes.