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Utah rates for HCPCS A6025

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

Facilitymedian $7 · 10th–90th $7–$70%50%100%$7Professionalmedian $13 · 10th–90th $7–$180%10%20%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $12.88 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $17.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $28.18 / $34.67
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $15.49 / $17.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $10.47 / $16.60