| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Facility | $191.40 | $191.40 | $191.40 | |
Cigna
| Professional | $139.72 | $139.72 | $197.14 |
Compression burn garment, glove to axilla, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Facility | $191.40 | $191.40 | $191.40 | |
Cigna
| Professional | $139.72 | $139.72 | $197.14 |