| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
Anthem BCBS
| Professional | $20.26 | $20.26 | $24.97 | |
Medica
| Facility | $35.00 | $38.04 | $77.84 | |
Medica
| Professional | $82.24 | $82.24 | $82.24 |
Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
Anthem BCBS
| Professional | $20.26 | $20.26 | $24.97 | |
Medica
| Facility | $35.00 | $38.04 | $77.84 | |
Medica
| Professional | $82.24 | $82.24 | $82.24 |