go back

Texas rates for HCPCS A4708

Acetate concentrate solution, for hemodialysis, per gallon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.70 / $11.70 / $11.70
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $16.20 / $16.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $6.00 / $12.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $6.00 / $12.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,250,000.00 / $2,400,000.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $21.13