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Illinois rates for HCPCS A6216

Gauze, nonimpregnated, nonsterile, pad size 16 sq in or less, without adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.87 / $4.00 / $8.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.50 / $0.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.06
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.13
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.07 / $0.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05