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Illinois 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
$385.86 / $385.86 / $385.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.59 / $300.85 / $423.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$664.29 / $944.46 / $1,246.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.65 / $487.65 / $487.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.63 / $359.63 / $526.29
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.25 / $208.49 / $260.94
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.82 / $291.39 / $518.13