| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.04 | $4.04 | $4.04 | |
Aetna
| Professional | $4.04 | $4.04 | $4.04 | |
CareFirst
| Professional | $8.00 | $8.00 | $8.00 | |
Cigna
| Professional | $2.98 | $2.98 | $2.98 |
Foam Dressing Wound Filler Per Gram
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.04 | $4.04 | $4.04 | |
Aetna
| Professional | $4.04 | $4.04 | $4.04 | |
CareFirst
| Professional | $8.00 | $8.00 | $8.00 | |
Cigna
| Professional | $2.98 | $2.98 | $2.98 |