go back

West Virginia 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
Professional
Modifier
Low / Median / High Price
$390.99 / $500.96 / $663.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.27 / $602.40 / $656.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.32 / $552.20 / $583.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.85 / $591.85 / $591.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.06 / $583.40 / $1,102.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.25 / $494.21 / $714.46