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Montana rates for HCPCS A6219

Gauze, nonimpregnated, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.80 / $3.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.40 / $1.40 / $1.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $1.40 / $1.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.27 / $1.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.05 / $1.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.56 / $0.65