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Virginia 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%20%10th90th$0Professionalmedian $6 · 10th–90th $0–$100%20%10th90th$6$0.1$1.0$10.0$100.0$1.0K$10.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $11.22
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $0.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.39 / $0.68
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $0.34 / $0.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.25 / $0.28 / $0.34
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.32 / $0.40 / $100.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.32 / $0.40 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.20 / $0.26 / $0.47