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Nebraska 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
$0.27 / $0.27 / $0.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.27 / $0.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.30 / $0.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.60 / $0.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.46 / $1.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.20 / $5.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.48 / $0.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.59 / $0.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.20 / $0.32