| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.00 | $6.00 | $6.00 |
Bicarbonate concentrate, solution, for hemodialysis, per gallon
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.00 | $6.00 | $6.00 |