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Mississippi 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
$0.28 / $0.28 / $0.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.28 / $0.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.80 / $16.80 / $18.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.00 / $16.00 / $16.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.19 / $0.38