go back

Wisconsin 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
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.05 / $1.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.34 / $0.47
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.22 / $0.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.23
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,900.00 / $5,900.00 / $5,900.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.17 / $0.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.20 / $0.35