| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
Anthem BCBS
| Professional | $14.13 | $14.13 | $14.13 |
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
Anthem BCBS
| Professional | $14.13 | $14.13 | $14.13 |