| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.00 | $90.00 | $90.00 | |
Aetna
| Professional | $90.00 | $90.00 | $90.00 | |
Cigna
| Facility | $151.56 | $151.56 | $151.56 | |
Cigna
| Professional | $90.80 | $90.80 | $103.75 |
Compression burn garment, glove to wrist, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.00 | $90.00 | $90.00 | |
Aetna
| Professional | $90.00 | $90.00 | $90.00 | |
Cigna
| Facility | $151.56 | $151.56 | $151.56 | |
Cigna
| Professional | $90.80 | $90.80 | $103.75 |