| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.00 | $35.00 | $35.00 | |
Providence
| Facility | $35.00 | $35.00 | $53.90 | |
Providence
| Professional | $1.70 | $1.78 | $2,250,000.00 |
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 | $21.00 | $35.00 | $35.00 | |
Providence
| Facility | $35.00 | $35.00 | $53.90 | |
Providence
| Professional | $1.70 | $1.78 | $2,250,000.00 |