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Indiana rates for HCPCS A4707

Bicarbonate conc pow per pac

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $5.14 / $5.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $15.00 / $20.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.18 / $19.80 / $19.80