| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $21.00 | $21.00 | $21.00 | |
MVP Health Care
| Professional | $21.00 | $21.00 | $21.00 |
Synthetic resorbable wound dressing, 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 |
|---|---|---|---|---|---|
Cigna
| Professional | $21.00 | $21.00 | $21.00 | |
MVP Health Care
| Professional | $21.00 | $21.00 | $21.00 |