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Iowa rates for HCPCS A6404

Gauze Non-Impregnated Sterile Pad Size More Than 48 Sq. In. Without Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.27 / $0.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.75 / $0.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.93 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.62 / $1.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.28 / $1.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.54 / $0.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.57 / $0.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.34
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.60 / $0.60