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Montana rates for HCPCS A6233

Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq in, each dressing

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.34 / $16.07 / $77.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.13 / $28.13 / $28.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.93 / $28.13 / $28.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.13 / $25.50 / $28.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.87 / $21.11 / $31.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.28 / $11.36 / $13.01