| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.45 | $5.45 | $5.45 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |
Dialysate Conc Pow Per Pack
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.45 | $5.45 | $5.45 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |