| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.67 | $34.67 | $34.67 | |
Anthem BCBS
| Professional | $14.13 | $18.62 | $30.20 | |
Martin's Point
| Professional | $34.67 | $34.67 | $41.69 |
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.67 | $34.67 | $34.67 | |
Anthem BCBS
| Professional | $14.13 | $18.62 | $30.20 | |
Martin's Point
| Professional | $34.67 | $34.67 | $41.69 |