| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.76 | $2.22 | $2.45 | |
Cigna
| Professional | $1.85 | $1.85 | $1.85 | |
United
| Professional | $1.63 | $2.06 | $3.35 |
Gauze, nonimpregnated, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.76 | $2.22 | $2.45 | |
Cigna
| Professional | $1.85 | $1.85 | $1.85 | |
United
| Professional | $1.63 | $2.06 | $3.35 |