| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $331.13 | $467.74 | |
CareSource
| Facility | $23.44 | $23.44 | $23.44 | |
SummaCare
| Facility | $501.19 | $501.19 | $501.19 | |
United
| Facility | $812.83 | $812.83 | $977.24 |
Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $331.13 | $467.74 | |
CareSource
| Facility | $23.44 | $23.44 | $23.44 | |
SummaCare
| Facility | $501.19 | $501.19 | $501.19 | |
United
| Facility | $812.83 | $812.83 | $977.24 |