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Texas 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
$0.08 / $0.11 / $0.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.11 / $0.14
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.00 / $11.00 / $11.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.13 / $0.33
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.11
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $80.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $3.54 / $3.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.13 / $0.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.14 / $0.17
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.16 / $0.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.13 / $0.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.10
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.15 / $0.20