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North Carolina 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
$0.32 / $0.32 / $0.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.32 / $0.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.40 / $0.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.23 / $0.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.37 / $4.13
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $4.13
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.20 / $0.33
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.64 / $85.00 / $90.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $5.52 / $5.52