go back

Texas rates for HCPCS A6404

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

Facilitymedian $0 · 10th–90th $0–$10%10%10th90th$0Professionalmedian $1 · 10th–90th $0–$10%20%10th90th$1$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.72 / $0.79 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $0.79
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $5.50
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $0.40 / $0.71
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.32 / $0.32 / $1.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $0.40 / $0.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.22 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.18 / $0.22 / $0.38
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $6.31