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Montana rates for HCPCS A6402

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

Facilitymedian $0 · 10th–90th $0–$00%50%10th90th$0Professionalmedian $0 · 10th–90th $0–$210%20%40%10th90th$0$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $9.33 / $20.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $77,624.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.16 / $0.16 / $0.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.16 / $0.16
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.28
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.15 / $0.21
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.23 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.08