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Texas 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–$20%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%50%10th90th$0$0.2$1.0$5.0$20.0

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
$1.23 / $2.51 / $2.51
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.56 / $1.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.28 / $0.28
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.43 / $0.44
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.36 / $0.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $0.31
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $4.27 / $4.27
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.35 / $0.52 / $0.87
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.55 / $1.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.89 / $1.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.35 / $0.52 / $0.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $0.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.17 / $0.24 / $0.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.21 / $0.28 / $0.37
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $0.58 / $0.58