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Tennessee 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
$1,160.00 / $1,160.00 / $1,160.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.70 / $509.70 / $717.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.01 / $581.16 / $1,014.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.82 / $607.73 / $1,065.31
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.65 / $1,196.65 / $2,542.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,266.93 / $3,786.99 / $4,193.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.55 / $522.17 / $886.49