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Utah rates for HCPCS A6404

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

Professionalmedian $0 · 10th–90th $0$10%20%10th90th$0$0.2$0.5$1.0$2.0$5.0$10.0$20.0

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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.91 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.36 / $0.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.47 / $0.65 / $0.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.32 / $0.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.22 / $0.33