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Oregon 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
$0.17 / $0.42 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.64 / $0.79 / $0.95
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.56 / $0.92
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.56 / $0.60
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.56 / $0.66
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.56 / $0.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.55 / $0.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.51 / $0.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.63 / $0.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.25 / $0.47