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Indiana 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
$13.61 / $13.61 / $13.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.51 / $10.11 / $13.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.78 / $4.78 / $9.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $10.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.90 / $20.45 / $44.62
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.61 / $17.53 / $46.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $13.47 / $18.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $9.71 / $18.54