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California rates for HCPCS A6258

Transparent film, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.61 / $1.77 / $17.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $2.81 / $17.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.95 / $2.31 / $3.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $2.67 / $5.60
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.32 / $8.88 / $12.73
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.99 / $15.20 / $22.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.02 / $6.62 / $8.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.01 / $7.53 / $13.85
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.22 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.98 / $29.98 / $45.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.30 / $6.02 / $8.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $6.44
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.35 / $11.35 / $11.35
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $3.60 / $4.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $2.71 / $8.05