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Montana rates for HCPCS A6025

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

Facilitymedian $28 · 10th–90th $14–$300%50%10th90th$28Professionalmedian $13 · 10th–90th $7–$230%10%10th90th$13$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $12.02 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $25.70 / $43.65
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $29.51
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $29.51
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $19.50 / $31.62
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $34.67 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $10.72 / $10.72