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Iowa 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
$12.88 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $12.02 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $39.81 / $50.12
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $46.77 / $151.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $21.88 / $43.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $14.13 / $40.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $26.92 / $38.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $33.11 / $44.67
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.55 / $9.55 / $14.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.55 / $16.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95