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Tennessee 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
$3.11 / $3.51 / $5.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $3.72 / $5.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $6.02 / $14.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.22 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.98 / $29.98 / $45.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.80 / $3.53