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California rates for HCPCS A6402

Gauze, nonimpregnated, sterile, pad size 16 sq in or less, without adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $22.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.14
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.25 / $0.36
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.39 / $0.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.17 / $0.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.20 / $0.40
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $3.54 / $3.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.15
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.18 / $0.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.20