| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.05 | $19.05 | $23.99 | |
Cigna
| Facility | $23.99 | $23.99 | $23.99 | |
Cigna
| Professional | $17.38 | $17.38 | $23.99 |
Nonstandard size or length
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.05 | $19.05 | $23.99 | |
Cigna
| Facility | $23.99 | $23.99 | $23.99 | |
Cigna
| Professional | $17.38 | $17.38 | $23.99 |