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Montana rates for HCPCS A2015

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

Facilitymedian $186 · 10th–90th $115–$3090%50%10th90th$186Professionalmedian $91 · 10th–90th $60–$1860%10%20%10th90th$91$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $724.44
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $199.53
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $199.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $177.83 / $724.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89