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Pennsylvania rates for HCPCS 90958

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 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
$476.87 / $476.87 / $476.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.53 / $476.87 / $609.67
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.24 / $517.04 / $799.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.26 / $569.26 / $569.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.11 / $550.84 / $938.04
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,086.16 / $1,086.16 / $1,086.16
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.21 / $680.40 / $1,018.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.58 / $491.67 / $1,306.23
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.39 / $324.39 / $324.39
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.39 / $749.20 / $1,011.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.26 / $569.26 / $569.26
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.11 / $550.11 / $936.37
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.21 / $488.21 / $488.21
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.81 / $488.21 / $507.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.76 / $470.04 / $801.34