go back

New Jersey rates for HCPCS A6404

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.31
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.33 / $0.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.25 / $0.44