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Self-Adherent Bandage, Elastic, Width 5 in or Greater

Utah rates for HCPCS A6455

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

Rates data updated July 2026.

Facilitymedian $1 · 10th–90th $1$10%50%$1Professionalmedian $1 · 10th–90th $1$30%10%10th90th$1$1.0$2.0$5.0$10.0$20.0$50.0

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.52
Median
$0.52
Typical High
$0.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.52
Median
$1.26
Typical High
$2.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.74
Typical High
$30.20
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.38
Typical High
$1.70
Select Health
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.00
Typical High
$2.04
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.00
Typical High
$2.40
United
Setting
Professional
Modifier
Global
Typical Low
$0.65
Median
$0.83
Typical High
$1.17