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Nebraska 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
$4.99 / $4.99 / $4.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $4.99 / $4.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.58 / $5.82 / $5.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.44 / $8.67 / $15.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.97 / $8.48 / $11.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $3.00 / $6.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.60 / $7.74 / $12.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $7.76 / $13.08
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $7.50 / $11.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $3.00 / $4.72