| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4.05 | $18.41 | $119.00 | |
Providence
| Facility | $4.05 | $18.41 | $130.90 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |
Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc, but less than or equal to 4999 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4.05 | $18.41 | $119.00 | |
Providence
| Facility | $4.05 | $18.41 | $130.90 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |