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Indiana 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
$0.14 / $0.14 / $0.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.09 / $0.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.20 / $0.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.18 / $0.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.08 / $0.12