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Montana 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

Facilitymedian $1 · 10th–90th $0–$10%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0–$30%20%10th90th$1$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$2.51 / $2.51 / $2.51
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.78 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.60 / $0.60
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.46 / $0.56 / $1.10
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.46 / $0.56 / $1.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.55 / $0.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.55 / $0.85 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.23 / $0.25 / $0.28