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Utah rates for HCPCS A6223

Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing

Professionalmedian $2 · 10th–90th $1–$40%20%40%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $14.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $3.02 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $2.40 / $2.40
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.39 / $3.47
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.47 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.45 / $2.14