go back

Oregon rates for HCPCS A6217

Gauze Non-Impregnated Non-Sterile Pad Size More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. Without Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.17 / $0.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $175.00 / $194.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.32
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.48 / $0.48
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $2.69 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.22 / $0.36