| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $35.00 | $35.00 | |
Aetna
| Professional | $3.80 | $3.80 | $3.80 | |
Moda Health
| Facility | $3.80 | $3.99 | $8.17 | |
Molina
| Professional | $30.00 | $55.00 | $3,500.00 |
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $35.00 | $35.00 | |
Aetna
| Professional | $3.80 | $3.80 | $3.80 | |
Moda Health
| Facility | $3.80 | $3.99 | $8.17 | |
Molina
| Professional | $30.00 | $55.00 | $3,500.00 |