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Idaho 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
$0.22 / $100.50 / $771.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.11 / $0.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.14 / $0.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.14 / $0.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.26 / $0.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.12