go back

Illinois rates for HCPCS A6404

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

Facilitymedian $110 · 10th–90th $63–$3890%10%10th90th$110Professionalmedian $1 · 10th–90th $0–$300%20%10th90th$1$0.1$0.5$2.0$10.0$50.0$200.0

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 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $112.20 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.10 / $158.49
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.19 / $0.19 / $0.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.22 / $0.37