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Missouri rates for HCPCS Q4110

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.41 / $94.95 / $99.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $66.70 / $91.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.83 / $35.90 / $48.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.70 / $61.70 / $65.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.40 / $65.40 / $83.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.88 / $87.01 / $163.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $65.41 / $360.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $65.41 / $80.00