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Arizona rates for HCPCS A2015

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $85.11 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $275.42 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $251.19 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $575.44 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $2,398.83 / $2,398.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $1,445.44 / $1,445.44