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Hawaii rates for HCPCS A6404

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.48 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.22 / $0.62