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Ohio 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
$902.53 / $902.53 / $902.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.39 / $500.96 / $652.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $507.56 / $782.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.05 / $584.46 / $723.40
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.33 / $608.80 / $681.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.50 / $631.57 / $1,002.59
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.89 / $648.57 / $974.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.09 / $557.16 / $802.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.34 / $524.40 / $893.17