| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Medica
| Facility | $80.00 | $100.00 | $100.00 |
Absorptive Wound Dressing For Use With Suction Pump Home Model Portable Pad Size More Than 16 Square Inches But Less Than Or Equal To 48 Square Inches
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Medica
| Facility | $80.00 | $100.00 | $100.00 |