| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.15 | $0.15 | $0.15 | |
Cigna
| Professional | $0.17 | $0.17 | $0.17 | |
MVP Health Care
| Professional | $0.17 | $0.17 | $0.17 | |
United
| Professional | $0.15 | $0.36 | $1.53 |
Gauze Non-Impregnated Non-Sterile Pad Size More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. Without Adhesive Border Each Dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.15 | $0.15 | $0.15 | |
Cigna
| Professional | $0.17 | $0.17 | $0.17 | |
MVP Health Care
| Professional | $0.17 | $0.17 | $0.17 | |
United
| Professional | $0.15 | $0.36 | $1.53 |