| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.15 | $0.15 | $0.33 | |
Cigna
| Professional | $0.56 | $0.56 | $0.56 | |
HMSA
| Professional | $0.94 | $0.98 | $0.98 | |
United
| Professional | $0.19 | $0.31 | $0.62 |
Gauze, nonimpregnated, nonsterile, pad size more than 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 | $0.33 | |
Cigna
| Professional | $0.56 | $0.56 | $0.56 | |
HMSA
| Professional | $0.94 | $0.98 | $0.98 | |
United
| Professional | $0.19 | $0.31 | $0.62 |