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Iowa rates for HCPCS A6403

Gauze Non-Impregnated Sterile Pad Size More Than 16 Sq. In. Less Than Or Equal To 48 Sq. In. Without Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.48 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.62 / $0.74 / $0.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.66 / $1.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.66 / $0.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.38 / $1.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $0.66 / $1.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.70 / $0.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.80 / $1.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.50
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.51 / $0.51 / $0.51
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.51 / $0.51