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North Carolina 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
$5.27 / $5.27 / $15.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $5.27 / $5.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.83 / $5.80 / $10.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.19 / $4.51 / $4.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $5.27 / $8.73
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $4.51 / $10.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $8.19 / $11.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $3.00 / $4.72
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.22 / $80.00 / $85.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.98 / $29.98 / $45.15