go back

Washington rates for HCPCS A6221

Gauze, nonimpregnated, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.69 / $3.84 / $4.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $2.92
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $100.00 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $5.53 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $1.89 / $1.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.86 / $3.49 / $3.49
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.35 / $7.35 / $79,999.20
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.35 / $7.35 / $7.35
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.20