| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.15 | $0.15 | $0.33 | |
Cigna
| Professional | $0.60 | $0.60 | $0.60 | |
HMSA
| Professional | $0.46 | $0.48 | $0.48 | |
United
| Professional | $0.14 | $0.22 | $0.62 |
Gauze, nonimpregnated, sterile, pad size more than 48 sq in, without adhesive border, each dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.15 | $0.15 | $0.33 | |
Cigna
| Professional | $0.60 | $0.60 | $0.60 | |
HMSA
| Professional | $0.46 | $0.48 | $0.48 | |
United
| Professional | $0.14 | $0.22 | $0.62 |