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Pennsylvania 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
$576.15 / $576.15 / $576.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.08 / $691.08 / $691.08
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,312.31 / $1,312.31 / $1,312.31
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.08 / $691.08 / $691.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$592.70 / $592.70 / $592.70