go back

Ohio 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
$8.91 / $15.85 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $12.02 / $15.85
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $6.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $13.80 / $22.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $60.26 / $75.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $9.77 / $15.14