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Minnesota rates for HCPCS A4680

Activated carbon filter for hemodialysis, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.54 / $30.54 / $30.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.98 / $30.54 / $40.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.42 / $135.66 / $385.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.25 / $53.77 / $63.82
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.84 / $127.05 / $303.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.25 / $50.25 / $57.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.54 / $54.70 / $94.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $28.58 / $170.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.23 / $26.78 / $49.92