go back

New York 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
$602.56 / $616.60 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $524.81 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $416.87 / $891.25
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $676.08 / $1,621.81
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $416.87 / $1,348.96
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $741.31 / $1,047.13
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $562.34
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $616.60 / $1,096.48
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $676.08 / $1,380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $524.81 / $1,047.13
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $660.69 / $1,148.15
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $562.34 / $1,288.25