| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Medica
| Facility | $50.00 | $100.00 | $100.00 |
Synthetic Resorbable Wound Dressing Sterile Pad Size 16 Sq. In. Or Less Without Adhesive Border Each Dressing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Medica
| Facility | $50.00 | $100.00 | $100.00 |