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
GAUZE; NON-IMPREGNATED; STERILE; PAD SIZE 16 SQ. IN. OR LESS; WITH ANY SIZE ADHESIVE BORDER; EACH DRESSING
Low
$0
Average
$6
Median
$2
High
$119
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
53 payers; the 90th percentile is 8.9× 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.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +19 other terms | 306 | $1 | $4 | $18 | 442% | — | $0 – $122 |
| 2 | Humana fee schedule · outpatient · +14 other terms | 304 | $1 | $2 | $3 | 120% | — | $1 – $34 |
| 3 | Aetna fee schedule · outpatient · +18 other terms | 271 | $1 | $1 | $1 | 48% | — | $1 – $9 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +12 other terms | 190 | $1 | $2 | $1 | 43% | — | $0 – $6 |
| 5 | WellCare fee schedule · outpatient · +8 other terms | 185 | $1 | $1 | $0 | 16% | — | $1 – $3 |
| 6 | Devoted fee schedule · outpatient · +4 other terms | 163 | $1 | $1 | $0 | 2% | — | $1 – $1 |
| 7 | Cigna Healthspring fee schedule · outpatient · +2 other terms | 116 | $1 | $1 | $0 | 3% | — | $1 – $1 |
| 8 | Molina fee schedule · outpatient · +10 other terms | 97 | $2 | $2 | $1 | 39% | — | $1 – $4 |
| 9 | Cigna fee schedule · outpatient · +16 other terms | 78 | $1 | $2 | $0 | 24% | — | $1 – $3 |
| 10 | Anthem fee schedule · outpatient · +13 other terms | 74 | $1 | $1 | $0 | 8% | — | $1 – $2 |
| 11 | Superior Healthplan fee schedule · outpatient | 41 | $1 | $2 | $1 | 40% | — | $1 – $8 |
| 12 | Kaiser fee schedule · outpatient · +7 other terms | 39 | $1 | $1 | $0 | 3% | — | $1 – $1 |
| 13 | Clover fee schedule · outpatient · +1 other terms | 37 | $1 | $1 | $0 | 3% | — | $1 – $1 |
| 14 | Bcbs Tx fee schedule · outpatient · +1 other terms | 31 | $1 | $1 | $0 | 30% | — | $1 – $5 |
| 15 | Caresource fee schedule · outpatient · +6 other terms | 30 | $1 | $70 | $60 | 85% | — | $1 – $122 |
| 16 | Optum fee schedule · outpatient · +3 other terms | 25 | $1 | $2 | $1 | 42% | — | $1 – $3 |
| 17 | Oscar fee schedule · outpatient · +5 other terms | 24 | $1 | $1 | $0 | 4% | — | $1 – $1 |
| 18 | Medicare fee schedule · outpatient · +3 other terms | 18 | $1 | $1 | $0 | 1% | — | $1 – $1 |
| 19 | Ambetter facility · fee schedule · outpatient · +9 other terms | 17 | $2 | $2 | $1 | 27% | — | $0 – $2 |
| 20 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 16 | $2 | $2 | $0 | 2% | — | $2 – $2 |
| 21 | Aetna Better Health fee schedule · outpatient · +4 other terms | 13 | $1 | $1 | $0 | 36% | — | $1 – $1 |
| 22 | Highmark facility · fee schedule · outpatient · +5 other terms | 13 | $2 | $2 | $1 | 51% | — | $1 – $4 |
| 23 | Wellmark fee schedule · both · +3 other terms | 13 | $1 | $1 | $0 | 3% | — | $1 – $1 |
| 24 | Bcbs Mn fee schedule · outpatient · +4 other terms | 12 | $1 | $1 | $0 | 47% | — | $0 – $1 |
| 25 | Bcbs Nj fee schedule · outpatient | 12 | $1 | $2 | $2 | 87% | — | $1 – $6 |
← Hospitals reporting HCPCS A6219 · Snapshot 20261111T120946Z-9134e7f7