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Michigan rates for HCPCS A4721

Dialysat sol fld vol > 999cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.40 / $14.48 / $29.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.67 / $6.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.60 / $39.60 / $39.60
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $1.20 / $20.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.44 / $20.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $75.00