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 MORE THAN 16 SQ. IN. LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING
Willits, CA
See all hospitals reporting HCPCS A6403 →Price type
Willits Hospital Inc’s median price of $21 is 3500% above the median hospital's median price ($1), higher than 99% of the 735 hospitals reporting HCPCS A6403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield blue shield mcare percent of total billed charges · outpatientfrom % of charges | $6 | $6 | — | — | — | $6 – $6 |
| 2 | Blue Cross Blue Shield tricare blue shield - all plans percent of total billed charges · outpatientfrom % of charges | $6 | $6 | — | — | — | $6 – $6 |
| 3 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $7 | $7 | — | — | — | $7 – $7 |
| 4 | Blue Cross Blue Shield blue cross mcs - all other plans case rate · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 5 | Blue Cross Blue Shield blue cross non mcs case rate · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 6 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 7 | Blue Cross Blue Shield blue shield epn percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 8 | Blue Cross Blue Shield blue shield - all other plans percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 9 | UnitedHealthcare uhc jll percent of total billed charges · outpatientfrom % of charges | $23 | $23 | — | — | — | $23 – $23 |
| 10 | UnitedHealthcare uhc all payer - all other plans percent of total billed charges · outpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 11 | First Health first health ppo - all plans percent of total billed charges · outpatientfrom % of charges | $25 | $25 | — | — | — | $25 – $25 |
| 12 | Cigna cigna - all plans percent of total billed charges · outpatientfrom % of charges | $26 | $26 | — | — | — | $26 – $26 |
| 13 | Medicaid medi-cal fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
Last updated: May 20, 2026
See Sterile gauze pad, 16 to 48 sq. in. pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.