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Pennsylvania rates for HCPCS A6228

Gauze, impregnated, water or normal saline, sterile, pad size 16 sq in or less, without adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $0.84 / $1.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.91 / $1.17
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.00 / $57,255.43 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.51 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $0.84 / $1.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.91 / $1.15
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.57 / $1.57 / $1.57
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.06
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.06 / $2.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $0.88 / $1.68