go back

Missouri rates for HCPCS 90957

End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.91 / $795.14 / $1,186.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.97 / $707.46 / $1,187.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.94 / $873.95 / $1,501.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.61 / $951.74 / $1,829.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.57 / $880.92 / $5,409.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.27 / $759.33 / $1,322.25