| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.02 | $3.02 | $3.80 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 |
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.02 | $3.02 | $3.80 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 |