| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.57 | $2.44 | $10.44 | |
Cigna
| Professional | $1.85 | $1.85 | $1.85 | |
MVP Health Care
| Professional | $1.85 | $1.85 | $1.85 | |
United
| Professional | $1.25 | $3.01 | $15.53 |
Gauze Non-Impregnated 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 | $1.57 | $2.44 | $10.44 | |
Cigna
| Professional | $1.85 | $1.85 | $1.85 | |
MVP Health Care
| Professional | $1.85 | $1.85 | $1.85 | |
United
| Professional | $1.25 | $3.01 | $15.53 |