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Utah 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
Facility
Modifier
Low / Median / High Price
$515.54 / $515.54 / $515.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.85 / $480.66 / $696.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.28 / $604.92 / $929.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.09 / $455.85 / $569.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.50 / $704.70 / $867.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.60 / $490.96 / $762.28