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Wisconsin rates for HCPCS 90955

End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$558.44 / $1,940.40 / $1,940.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,362.49 / $1,592.18 / $2,442.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.53 / $558.44 / $942.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.67 / $558.44 / $1,040.35
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.53 / $554.62 / $942.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.10 / $1,201.69 / $1,713.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.32 / $1,050.04 / $2,358.53