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Montana 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
Professional
Modifier
Low / Median / High Price
$99.03 / $117.26 / $187.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $68,099.99 / $68,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.34 / $190.34 / $190.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.34 / $190.34 / $190.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.86 / $164.19 / $326.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.34 / $159.90 / $288.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.52 / $250.47 / $326.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.84 / $198.24 / $237.19