| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.12 | $50.12 | $57.54 | |
Molina
| Professional | $6.76 | $30.20 | $44.67 | |
U of Utah Health Plan
| Professional | $5.25 | $5.25 | $5.25 |
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 | $50.12 | $50.12 | $57.54 | |
Molina
| Professional | $6.76 | $30.20 | $44.67 | |
U of Utah Health Plan
| Professional | $5.25 | $5.25 | $5.25 |