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Ohio rates for HCPCS 90963

End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $645.65 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24