| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $650.00 | $650.00 | $650.00 | |
Cigna
| Facility | $860.00 | $860.00 | $860.00 | |
Pacific Source
| Facility | $600.00 | $600.00 | $600.00 |
Inpatient Renal Dialysis - Inpatient Peritoneal (Non-CAPD)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $650.00 | $650.00 | $650.00 | |
Cigna
| Facility | $860.00 | $860.00 | $860.00 | |
Pacific Source
| Facility | $600.00 | $600.00 | $600.00 |