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Utah rates for HCPCS A6253

Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing

Facilitymedian $2 · 10th–90th $2–$20%50%100%$2Professionalmedian $5 · 10th–90th $2–$120%10%20%10th90th$5$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $5.01 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $4.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $7.94 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $6.31 / $6.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $8.91 / $9.12
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $9.12 / $10.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.95 / $3.80 / $5.62