| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.01 | $5.01 | $12.30 | |
Aetna
| Professional | $5.01 | $5.01 | $5.50 | |
Molina
| Professional | $32.36 | $33.11 | $75.86 |
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.01 | $5.01 | $12.30 | |
Aetna
| Professional | $5.01 | $5.01 | $5.50 | |
Molina
| Professional | $32.36 | $33.11 | $75.86 |