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Maine 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
Professional
Modifier
Low / Median / High Price
$2.63 / $3.45 / $4.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $2.67 / $2.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $4.90
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $3.45 / $3.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.00 / $6.92