| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Facility | $134.61 | $134.61 | $134.61 | |
Cigna
| Professional | $98.27 | $98.27 | $138.65 |
Compression burn garment, glove to elbow, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Facility | $134.61 | $134.61 | $134.61 | |
Cigna
| Professional | $98.27 | $98.27 | $138.65 |