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Pennsylvania rates for HCPCS A6204

Composite Dressing Pad Size More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. With Any Size Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.26 / $4.26 / $6.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $5.33 / $7.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.00 / $57,255.43 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.69 / $8.69 / $8.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.19 / $10.19 / $10.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.11 / $11.77 / $12.60
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.87 / $5.87 / $6.52
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.26 / $4.26 / $6.77
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.03 / $5.33 / $10.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $12.40 / $17.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.19 / $10.19 / $10.19
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.22 / $6.54 / $8.27
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.22 / $8.27 / $8.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.33 / $4.34 / $7.60