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Montana rates for HCPCS A4755

Blood tubing, arterial and venous combined, for hemodialysis, each

Facilitymedian $9 · 10th–90th $8–$170%50%10th90th$9Professionalmedian $8 · 10th–90th $8–$100%50%90th$8$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $9.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $8.51 / $16.60
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $79.43