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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
$30.20 / $30.20 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $32.36 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $162.18 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $53.70 / $63.10
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $162.18 / $316.23
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $67.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $51.29 / $93.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $28.84 / $346.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $28.84 / $58.88