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Arizona rates for HCPCS A6404

Gauze, nonimpregnated, sterile, pad size more than 48 sq in, without adhesive border, each dressing

Facilitymedian $0 · 10th–90th $0–$20%5%10th90th$0Professionalmedian $0 · 10th–90th $0–$10%20%10th90th$0$0.2$1.0$5.0$20.0$100.0

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
$1.00 / $1.00 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.27 / $0.48 / $1.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.12 / $1.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.19 / $0.36 / $0.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.18 / $0.22 / $0.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.17 / $0.22 / $0.38