go back

Montana 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
$514.14 / $645.94 / $1,186.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,198.82 / $1,198.82 / $1,198.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.32 / $853.69 / $1,849.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$720.14 / $873.83 / $1,518.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.49 / $1,418.13 / $2,049.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.00 / $1,056.71 / $1,228.50