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Michigan 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
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.44 / $0.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $1.72 / $3.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.56 / $0.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.77 / $0.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.74 / $1.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.94
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $2.78
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.43 / $0.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.37 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.28 / $0.43