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Pennsylvania 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
$297.52 / $297.52 / $297.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.47 / $297.52 / $382.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.26 / $500.46 / $500.46
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 / $359.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.47 / $300.85 / $405.70
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.10 / $595.10 / $595.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.65 / $487.65 / $487.65
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.63 / $359.63 / $359.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.83 / $283.23 / $544.04