go back

Oregon rates for HCPCS A4755

Blood Tubing Arterial And Venous Combined For Hemodialysis Each (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.00 / $9.00 / $9.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $178.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $14.72
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $17.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,250,000.00 / $2,250,000.00 / $2,400,000.00