| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,180.13 | $1,180.13 | $1,180.13 | |
Medica
| Facility | $476.40 | $616.10 | $1,180.13 |
End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,180.13 | $1,180.13 | $1,180.13 | |
Medica
| Facility | $476.40 | $616.10 | $1,180.13 |