| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.41 | $9.41 | $9.41 | |
Aetna
| Professional | $9.27 | $11.21 | $15.87 | |
Cigna
| Professional | $13.47 | $13.47 | $13.47 | |
United
| Professional | $7.42 | $11.81 | $19.39 |
Gel Sheet For Dermal Or Epidermal Application (E.G. Silicone Hydrogel Other) Each. (Rvsd 1/1/04)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.41 | $9.41 | $9.41 | |
Aetna
| Professional | $9.27 | $11.21 | $15.87 | |
Cigna
| Professional | $13.47 | $13.47 | $13.47 | |
United
| Professional | $7.42 | $11.81 | $19.39 |