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Michigan rates for HCPCS A2001

InnovaMatrix AC, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $12,103.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,275.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $1,275.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $12,103.14
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,275.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,250.00 / $1,250.00 / $1,347.25