go back

Texas 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
$1.49 / $3.96 / $5,425.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $3.95 / $5.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.55 / $6.75 / $16.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $2.87 / $2.87
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.51 / $6.60
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $4.51 / $4.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $1.15 / $1.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.61 / $3.61 / $7.06
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.95 / $4.73 / $7.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $5.72 / $6.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $6.92 / $11.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $4.73 / $7.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $5.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.13 / $2.78 / $3.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $6.02 / $8.13