| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.00 | $8.00 | $8.00 | |
Aetna
| Professional | $8.00 | $8.00 | $8.00 |
Miscellaneous Dialysis Supplies Not Otherwise Specified (Special Coverage Instructions Apply)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.00 | $8.00 | $8.00 | |
Aetna
| Professional | $8.00 | $8.00 | $8.00 |