Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HB-Dress Gauze 4x4
Low
$0
Average
$6
Median
$0
High
$118
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
50 payers; the 90th percentile is 172.5× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +18 other terms | 304 | $0 | $3 | $18 | 630% | — | $0 – $122 |
| 2 | Humana fee schedule · outpatient · +12 other terms | 303 | $0 | $0 | $0 | 133% | — | $0 – $1 |
| 3 | Aetna fee schedule · outpatient · +16 other terms | 267 | $0 | $0 | $0 | 133% | — | $0 – $1 |
| 4 | WellCare fee schedule · outpatient · +8 other terms | 185 | $0 | $0 | $0 | 117% | — | $0 – $1 |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +13 other terms | 175 | $0 | $0 | $0 | 180% | — | $0 – $2 |
| 6 | Devoted fee schedule · outpatient · +6 other terms | 163 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Cigna Healthspring fee schedule · outpatient · +2 other terms | 116 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Molina fee schedule · outpatient · +9 other terms | 97 | $0 | $0 | $0 | 43% | — | $0 – $0 |
| 9 | Cigna fee schedule · outpatient · +15 other terms | 77 | $0 | $0 | $0 | 20% | — | $0 – $0 |
| 10 | Anthem fee schedule · outpatient · +12 other terms | 74 | $0 | $0 | $0 | 193% | — | $0 – $1 |
| 11 | Superior Healthplan fee schedule · outpatient · +1 other terms | 40 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Kaiser fee schedule · outpatient · +5 other terms | 39 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Clover fee schedule · outpatient · +1 other terms | 37 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Bcbs Tx fee schedule · outpatient | 31 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 15 | Caresource fee schedule · outpatient · +5 other terms | 30 | $0 | $70 | $60 | 87% | — | $0 – $122 |
| 16 | Optum fee schedule · outpatient · +5 other terms | 25 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 17 | Oscar fee schedule · outpatient · +6 other terms | 24 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Medicare fee schedule · outpatient · +1 other terms | 18 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Ambetter facility · fee schedule · outpatient · +7 other terms | 16 | $0 | $0 | $0 | 25% | — | $0 – $0 |
| 20 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 16 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Aetna Better Health fee schedule · outpatient · +6 other terms | 13 | $0 | $0 | $0 | 25% | — | $0 – $0 |
| 22 | Wellmark fee schedule · both · +3 other terms | 13 | $0 | $0 | $0 | 117% | — | $0 – $1 |
| 23 | Bcbs Mn fee schedule · outpatient · +4 other terms | 12 | $0 | $0 | $0 | 140% | — | $0 – $1 |
| 24 | Bcbs Nj fee schedule · outpatient | 12 | $0 | $0 | $0 | 64% | — | $0 – $0 |
| 25 | Highmark fee schedule · outpatient · +5 other terms | 10 | $0 | $0 | $0 | 40% | — | $0 – $0 |
← Hospitals reporting HCPCS A6216 · Snapshot 20261111T120946Z-9134e7f7