| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Medica
| Facility | $10.00 | $10.00 | $11.50 | |
Medica
| Professional | $29.12 | $29.12 | $29.12 |
Drain Bag/Bottle For Dialysis Each (Special Coverage Instructions Apply)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Medica
| Facility | $10.00 | $10.00 | $11.50 | |
Medica
| Professional | $29.12 | $29.12 | $29.12 |