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Alaska rates for HCPCS A2002

Mirragen Advanced Wound Matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $128.82 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $302.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $194.98 / $275.42
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $309.03 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $3,467.37 / $3,467.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $177.83 / $269.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $190.55 / $380.19