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Indiana rates for HCPCS A6404

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

Facilitymedian $6 · 10th–90th $4–$120%50%10th90th$6Professionalmedian $5 · 10th–90th $0–$90%10%20%10th90th$5$0.1$0.5$2.0$10.0$50.0

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
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
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
$6.31 / $6.31 / $12.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $6.31 / $9.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.30 / $0.33 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.21 / $0.35