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Maine rates for HCPCS A6403

Gauze, nonimpregnated, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing

Professionalmedian $1 · 10th–90th $0–$10%50%10th90th$1$0.2$0.5$1.0$2.0

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
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.20 / $1.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.27 / $0.27 / $0.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $0.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.20 / $1.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.21 / $0.48 / $0.50