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Missouri rates for HCPCS 90947

Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.00 / $629.05 / $629.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.51 / $127.29 / $187.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.08 / $105.08 / $115.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.24 / $141.87 / $226.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $200.00 / $510.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.78 / $157.97 / $266.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.79 / $165.07 / $294.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.90 / $162.38 / $1,165.68
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.85 / $136.85 / $136.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.02 / $144.19 / $249.49