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Maryland 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
$2.77 / $5.94 / $7.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $4.07 / $6.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $3.35 / $3.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.02 / $7.65 / $9.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $3.00 / $4.91
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $2.67 / $5.12