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Utah rates for HCPCS A6454

Self-adherent bandage, elastic, nonknitted/nonwoven, width greater than or equal to 3 in and less than 5 in, per yd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.62 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $1.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.77 / $0.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.46 / $0.65