| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $977.24 | $977.24 | $977.24 | |
Medcost
| Professional | $758.58 | $758.58 | $831.76 | |
Medcost
| Facility | $562.34 | $758.58 | $1,202.26 |
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 |
|---|---|---|---|---|---|
Cigna
| Facility | $977.24 | $977.24 | $977.24 | |
Medcost
| Professional | $758.58 | $758.58 | $831.76 | |
Medcost
| Facility | $562.34 | $758.58 | $1,202.26 |