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Rhode Island 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
$0.20 / $0.20 / $0.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.23 / $0.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $2.21 / $2.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.12 / $1.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.23 / $0.38