| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.19 | $2.19 | $2.19 | |
Cigna
| Professional | $0.31 | $0.31 | $0.31 | |
United
| Professional | $0.27 | $0.32 | $0.49 |
Gauze, nonimpregnated, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.19 | $2.19 | $2.19 | |
Cigna
| Professional | $0.31 | $0.31 | $0.31 | |
United
| Professional | $0.27 | $0.32 | $0.49 |