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Arizona rates for HCPCS A6025

Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $9.27 / $9.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.51 / $9.27 / $16.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.75 / $60.00 / $141.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.47 / $13.47 / $13.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $18.76 / $32.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.51 / $10.61 / $26.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $10.61 / $18.66