| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.02 | $3.02 | $3.02 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Medcost
| Facility | $3.80 | $3.98 | $8.13 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.02 | $3.02 | $3.02 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Medcost
| Facility | $3.80 | $3.98 | $8.13 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |