| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Cigna
| Facility | $424.08 | $424.08 | $424.08 | |
Cigna
| Professional | $309.58 | $309.58 | $436.80 |
Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Cigna
| Facility | $424.08 | $424.08 | $424.08 | |
Cigna
| Professional | $309.58 | $309.58 | $436.80 |