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North Dakota 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
$0.21 / $0.23 / $0.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.44 / $1.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.59 / $0.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.76 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.45 / $0.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.20 / $0.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.18 / $0.36