go back

Wisconsin rates for HCPCS A4680

Activated carbon filter for hemodialysis, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $33.88 / $43.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $60.26 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $141.25 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $53.70 / $93.33
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $35.48 / $48.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $35.48 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $28.84 / $346.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $97.72 / $144.54
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $288.40
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $93.33 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $26.92 / $51.29