go back

Illinois rates for HCPCS A6402

Gauze Non-Impregnated Sterile Pad Size 16 Sq. In. Or Less Without Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.09 / $0.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.62 / $1.41 / $6.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.16
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.17 / $0.52
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.20 / $0.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.14