| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.01 | $5.01 | $5.01 | |
Molina
| Professional | $7.08 | $10.00 | $70.79 | |
Providence
| Facility | $5.50 | $5.50 | $281.84 |
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.01 | $5.01 | $5.01 | |
Molina
| Professional | $7.08 | $10.00 | $70.79 | |
Providence
| Facility | $5.50 | $5.50 | $281.84 |