go back

Connecticut rates for HCPCS A4736

Topical Anesthetic For Dialysis Per Gram (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $15.00 / $15.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.30 / $1.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.68 / $1.68
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64,999.35 / $64,999.35 / $64,999.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00