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Virginia 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%10th90th$1Professionalmedian $0 · 10th–90th $0–$10%20%40%10th90th$0$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$1.20 / $1.20 / $1.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.27 / $0.27 / $0.52
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.36 / $0.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $0.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.46 / $0.65 / $1.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.43 / $0.65
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.33 / $0.49 / $0.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.32 / $0.39 / $0.39
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.43 / $0.54 / $100.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.54 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.37 / $0.37 / $0.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.27 / $0.28 / $0.48