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New Hampshire rates for HCPCS 90964

End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 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
$1,414.76 / $1,414.76 / $1,414.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.39 / $468.61 / $610.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.20 / $604.48 / $847.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.85 / $741.67 / $1,324.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.74 / $857.61 / $1,764.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.71 / $698.37 / $1,266.40
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.89 / $403.58 / $513.65