| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.15 | $37.15 | $37.15 | |
Aetna
| Professional | $28.84 | $28.84 | $37.15 | |
Cigna
| Professional | $870.96 | $870.96 | $870.96 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 |
Compression burn mask, face and/or neck, plastic or equal, custom fabricated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.15 | $37.15 | $37.15 | |
Aetna
| Professional | $28.84 | $28.84 | $37.15 | |
Cigna
| Professional | $870.96 | $870.96 | $870.96 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 |