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Virginia 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 / $715.03 / $902.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.26 / $869.24 / $1,300.15
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$792.26 / $880.29 / $1,624.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$876.11 / $876.11 / $876.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$650.01 / $838.66 / $1,495.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.50 / $839.12 / $1,116.49
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.54 / $780.30 / $1,197.65
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.00 / $910.00 / $1,331.96
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$675.41 / $824.50 / $1,346.60
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.41 / $824.50 / $1,346.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.07 / $698.54 / $1,095.67