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Washington rates for HCPCS A4623

Tracheostomy Inner Cannula. (Rvsd 1/1/04) Ecial Coverage Instructions Apply. See Cim: 65-16)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.19 / $11.78 / $12.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $5.19 / $10.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.41 / $8.50 / $9.16
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.02 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.14 / $7.79 / $45.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $6.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.68 / $6.62
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.27 / $9.16 / $14.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.27 / $9.22 / $16.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.96 / $7.95 / $9.72
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.18 / $7.61 / $9.16
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.80 / $7.79 / $9.16
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.61 / $8.02 / $14.84
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.61 / $8.27 / $13.17
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.27 / $7.79 / $9.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $4.19 / $7.41
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.90 / $6.71 / $6.71