| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $576.15 | $1,375.06 | $2,200.55 | |
Providence
| Facility | $576.15 | $1,375.06 | $2,200.55 |
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $576.15 | $1,375.06 | $2,200.55 | |
Providence
| Facility | $576.15 | $1,375.06 | $2,200.55 |