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Idaho rates for HCPCS A4690

Dialyzer (Artificial Kidneys) All Types All Sizes For Hemodialysis Each (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$384.17 / $384.17 / $384.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.59 / $370.56 / $615.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.63 / $359.63 / $359.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.56 / $502.79 / $779.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,500.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.11 / $476.11 / $476.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.82 / $280.99 / $283.23