| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.03 | $6.03 | $6.03 | |
Molina
| Professional | $10.47 | $15.14 | $70.79 | |
Providence
| Facility | $6.03 | $6.03 | $9.33 | |
Providence
| Professional | $21.38 | $21.38 | $21.38 |
Bicarbonate concentrate, solution, for hemodialysis, per gallon
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.03 | $6.03 | $6.03 | |
Molina
| Professional | $10.47 | $15.14 | $70.79 | |
Providence
| Facility | $6.03 | $6.03 | $9.33 | |
Providence
| Professional | $21.38 | $21.38 | $21.38 |