| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $247.85 | $247.85 | $11,342.03 | |
Aetna
| Professional | $5.81 | $5.81 | $390.25 | |
Horizon BCBS
| Facility | $1,638.41 | $1,701.16 | $3,454.96 |
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 | $247.85 | $247.85 | $11,342.03 | |
Aetna
| Professional | $5.81 | $5.81 | $390.25 | |
Horizon BCBS
| Facility | $1,638.41 | $1,701.16 | $3,454.96 |