| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
BCBS
| Professional | $14.03 | $14.03 | $14.03 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |
Compression Burn Garment Facial Hood Custom Fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
BCBS
| Professional | $14.03 | $14.03 | $14.03 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |