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Missouri rates for HCPCS A6404

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.28 / $0.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.20 / $0.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.49 / $6.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.34 / $0.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.21 / $5.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.21 / $0.35