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Massachusetts 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
$2.63 / $2.63 / $2.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $2.94 / $3.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $8.93 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.94 / $5.88 / $29.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.55 / $7.77 / $9.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.70 / $3.70 / $3.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.66
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.05 / $4.05
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $4.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.22 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $3.44 / $29.98
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.84 / $3.84 / $3.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $3.44 / $8.19