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Oklahoma rates for HCPCS A6404

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

Facilitymedian $0 · 10th–90th $0–$30%20%40%10th90th$0Professionalmedian $0 · 10th–90th $0–$10%20%40%10th90th$0$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.20 / $0.26 / $0.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.22 / $5.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.20 / $0.20 / $0.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.19 / $0.38