| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.01 | $5.01 | $5.01 |
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 |