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Kentucky 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
Facility
Modifier
Low / Median / High Price
$0.16 / $0.18 / $0.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.20 / $0.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $7.50 / $7.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.41 / $0.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.39 / $0.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.67 / $0.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.60 / $0.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.06 / $2.14 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.20 / $0.28