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Maryland rates for HCPCS A6404

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.27 / $0.36
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.46 / $0.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.26 / $0.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $6.38 / $6.38