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California rates for HCPCS A6404

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

Facilitymedian $6 · 10th–90th $5–$150%20%40%10th90th$6Professionalmedian $1 · 10th–90th $0–$60%10%20%10th90th$1$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $6.03 / $15.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $6.31 / $7.59
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $0.68 / $1.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $154.88
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $5.50
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.21 / $0.44 / $0.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.50 / $0.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.22 / $0.42