go back

Illinois rates for HCPCS A2015

Phoenix wound matrix, per square centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.16 / $68.16 / $842.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.95 / $72.81 / $114.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.24 / $785.24 / $785.24
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $200.00 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $40.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,438.66 / $1,438.66 / $1,526.42