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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 October 2026.

How much does Self-Adherent Bandage, Elastic, Width 5 in or Greater cost?

$0.83

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $0.83 for this service. Most negotiated rates run $0.65 to $1.38.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $1 to $2
$1$2$5$10$20facility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.52
Median
$0.52
Typical High
$0.52
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.52
Median
$0.52
Typical High
$1.07
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.27
Median
$0.27
Typical High
$0.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.11
Median
$0.11
Typical High
$0.21
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.08
Median
$0.08
Typical High
$0.16
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.05
Median
$0.05
Typical High
$0.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
Molina
Setting
Professional
Modifier
None
Typical Low
$1.41
Median
$1.41
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$1.38
Select Health
Setting
Facility
Modifier
None
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Select Health
Setting
Professional
Modifier
None
Typical Low
$1.95
Median
$2.00
Typical High
$2.04
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$1.41
Median
$2.00
Typical High
$2.82
United
Setting
Professional
Modifier
None
Typical Low
$0.65
Median
$0.83
Typical High
$1.62

Where Utah sits

The same service costs 2.6 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 51st of 51

$0.83

HI $2.14UT $0.83

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.