| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.80 | $5.80 | $5.80 | |
Aetna
| Professional | $5.81 | $5.81 | $178.52 | |
BCBS
| Professional | $81.26 | $104.18 | $981.25 | |
Cigna
| Professional | $90.00 | $90.00 | $90.00 |
Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.80 | $5.80 | $5.80 | |
Aetna
| Professional | $5.81 | $5.81 | $178.52 | |
BCBS
| Professional | $81.26 | $104.18 | $981.25 | |
Cigna
| Professional | $90.00 | $90.00 | $90.00 |