go back

Rhode Island rates for HCPCS A6404

Gauze, nonimpregnated, 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