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Pennsylvania 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
$0.08 / $0.10 / $5.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.13
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.00 / $57,255.43 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.18 / $0.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.20 / $0.22
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.13 / $5.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.14
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $0.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.18 / $0.18
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.13 / $0.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.16