| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
Anthem BCBS
| Professional | $12.38 | $20.26 | $20.26 |
Dialysate Solution Any Concentration Of Dextrose Fluid Volume Greater Than 5999cc For Peritoneal Dialysis (Special Coverage Instructions Apply. See Mcm: 4270)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
Anthem BCBS
| Professional | $12.38 | $20.26 | $20.26 |