| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $20.00 | $20.00 | $25.00 |
Replace Components For Hemodialysis And/Or Peritoneal Dialysis M
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $20.00 | $20.00 | $25.00 |