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New Hampshire 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
$349.48 / $349.48 / $349.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.04 / $122.18 / $144.06
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.89 / $387.56 / $387.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.42 / $142.11 / $199.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.36 / $195.08 / $315.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.41 / $201.63 / $414.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.76 / $173.61 / $322.48
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.74 / $114.78 / $168.89