| 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
| Professional | $196.48 | $196.48 | $196.48 | |
Horizon BCBS
| Professional | $10.63 | $10.63 | $12.50 |
Compression burn garment, lower trunk including leg openings (panty), 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
| Professional | $196.48 | $196.48 | $196.48 | |
Horizon BCBS
| Professional | $10.63 | $10.63 | $12.50 |