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Montana rates for HCPCS A4680

Activated carbon filter for hemodialysis, each

Facilitymedian $76 · 10th–90th $34–$890%20%10th90th$76Professionalmedian $34 · 10th–90th $20–$500%10%10th90th$34$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $33.88 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $69.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $54.95 / $93.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $69.18 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $28.84 / $28.84