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Montana rates for HCPCS 90965

End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 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
$361.90 / $455.45 / $696.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$778.71 / $778.71 / $778.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.96 / $599.67 / $1,202.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.75 / $583.61 / $988.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.64 / $919.38 / $1,327.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.08 / $742.41 / $853.47