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Michigan rates for HCPCS A4719

"Y set" tubing for peritoneal dialysis

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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.60 / $9.65 / $19.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.42 / $3.78 / $4.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.24 / $9.24 / $9.24
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $75.00