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Missouri 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
$47.91 / $113.19 / $113.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.91 / $68.16 / $113.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.54 / $105.60 / $138.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.37 / $785.24 / $785.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.62 / $113.19 / $1,835.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,438.66 / $1,438.66 / $4,904.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,409.89 / $1,438.66 / $1,712.01