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Idaho rates for HCPCS A4774

Ammonia test strips, for dialysis, per 50

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.13 / $31.13 / $31.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $3.20 / $4.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.20 / $3.36 / $6.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $55.00 / $3,500.00