| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $628.00 | $628.00 | $628.00 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $79.43 | $79.43 | $79.43 |
Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $628.00 | $628.00 | $628.00 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $79.43 | $79.43 | $79.43 |