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Missouri rates for HCPCS Q4108

Integra matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.70 / $74.79 / $78.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $39.31 / $46.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.32 / $24.13 / $45.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.36 / $36.36 / $38.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $49.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.12 / $68.64 / $122.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.12 / $49.12 / $197.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $47.13