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Virginia 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
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $4.73 / $7.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.84 / $10.84 / $10.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.00 / $95.00 / $105.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $13.52
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $4,071.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $4,071.00