| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.98 | $3.98 | $3.98 | |
Aetna
| Professional | $3.98 | $3.98 | $3.98 | |
Cigna
| Professional | $1.78 | $1.78 | $1.78 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Specialty absorptive dressing, wound cover, 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
| Facility | $3.98 | $3.98 | $3.98 | |
Aetna
| Professional | $3.98 | $3.98 | $3.98 | |
Cigna
| Professional | $1.78 | $1.78 | $1.78 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |