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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
$1,148.15 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $524.81 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $645.65 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $602.56 / $1,000.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,235.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,168.69 / $4,168.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $537.03 / $870.96