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Montana rates for HCPCS A6258

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

Facilitymedian $6 · 10th–90th $4–$150%20%40%10th90th$6Professionalmedian $3 · 10th–90th $2–$70%20%10th90th$3$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $14.79 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $5.37
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $87,096.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $5.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $6.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $6.31 / $6.31
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.68 / $5.89 / $11.48
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $5.89 / $11.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.47 / $5.75 / $7.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.31 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.51 / $3.16