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Rhode Island 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
$4.27 / $4.27 / $4.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.02 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $12.02 / $14.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.16 / $5.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $3.47 / $5.01