| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
Medica
| Facility | $5.00 | $5.00 | $5.75 | |
Medica
| Professional | $12.47 | $12.47 | $12.47 |
Acid concentrate, solution, for hemodialysis, per gallon
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
Medica
| Facility | $5.00 | $5.00 | $5.75 | |
Medica
| Professional | $12.47 | $12.47 | $12.47 |