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California rates for HCPCS A4719

Y Set Tubing For Peritoneal Dialysis (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $7.00 / $7.00
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.18 / $16.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.77 / $638.07 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.45 / $72.45 / $75.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $70.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $5.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,400,000.00 / $2,400,000.00