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North Dakota rates for HCPCS A2005

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.36 / $233.36 / $233.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.41 / $182.08 / $233.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.38 / $216.38 / $216.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.36 / $318.20 / $469.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.57 / $254.57 / $285.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.57 / $254.57 / $285.12