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Massachusetts rates for HCPCS A6404

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

Facilitymedian $2 · 10th–90th $1–$5,8880%20%10th90th$2Professionalmedian $1 · 10th–90th $0–$10%50%10th90th$1$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.65 / $1.29 / $89.13
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.20 / $0.43 / $0.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $93.33 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.62 / $0.62 / $0.62
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.65 / $1.29 / $89.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.20 / $0.43 / $0.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.22 / $0.40 / $0.62