| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.26 | $0.41 | $1.70 | |
Cigna
| Professional | $0.31 | $0.31 | $0.31 | |
MVP Health Care
| Professional | $0.31 | $0.31 | $0.31 | |
United
| Professional | $0.20 | $0.45 | $2.48 |
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 | $0.26 | $0.41 | $1.70 | |
Cigna
| Professional | $0.31 | $0.31 | $0.31 | |
MVP Health Care
| Professional | $0.31 | $0.31 | $0.31 | |
United
| Professional | $0.20 | $0.45 | $2.48 |