| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.45 | $5.45 | $5.45 | |
Medica
| Facility | $5.45 | $5.45 | $6.54 | |
Medica
| Professional | $6.06 | $6.06 | $6.06 |
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.45 | $5.45 | $5.45 | |
Medica
| Facility | $5.45 | $5.45 | $6.54 | |
Medica
| Professional | $6.06 | $6.06 | $6.06 |