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Missouri 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
$3.66 / $4.80 / $4.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $3.38 / $6.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $3.32 / $5.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.34 / $6.02 / $13.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $3.00 / $29.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.00 / $4.51