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Maryland rates for HCPCS A6025

Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.21 / $13.06 / $17.48
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.25 / $24.25 / $24.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.47 / $13.47 / $13.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.09 / $22.67 / $38.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.39 / $11.81 / $20.70
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $4.78 / $4.78