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Missouri rates for HCPCS A2013

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,296.00 / $1,701.00 / $1,701.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,296.00 / $1,296.00 / $1,377.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$821.71 / $1,038.67 / $1,361.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,377.00 / $1,377.00 / $1,377.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,377.00 / $1,377.00 / $1,377.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,296.00 / $1,620.00 / $3,238.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,350.00 / $1,350.00 / $5,814.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,350.00 / $1,350.00 / $1,587.60