| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.69 | $2.56 | $2.80 | |
Cigna
| Professional | $1.89 | $1.89 | $1.89 | |
HMSA
| Professional | $4.16 | $4.36 | $4.36 |
Gauze, nonimpregnated, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.69 | $2.56 | $2.80 | |
Cigna
| Professional | $1.89 | $1.89 | $1.89 | |
HMSA
| Professional | $4.16 | $4.36 | $4.36 |