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Missouri rates for HCPCS Q4217

WoundFix, BioWound, WoundFix Plus, BioWound Plus, WoundFix Xplus or BioWound Xplus, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.36 / $1,522.50 / $1,522.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $324.36 / $381.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.01 / $743.78 / $1,000.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $300.00 / $318.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $405.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.36 / $483.91 / $1,450.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.20 / $318.00 / $1,994.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $388.91