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Utah 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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.22 / $0.36