| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $513.11 | $513.11 | $523.07 | |
CareSource
| Facility | $452.32 | $657.92 | $781.28 | |
Cigna
| Facility | $594.32 | $594.32 | $594.32 |
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 | $513.11 | $513.11 | $523.07 | |
CareSource
| Facility | $452.32 | $657.92 | $781.28 | |
Cigna
| Facility | $594.32 | $594.32 | $594.32 |