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Illinois rates for HCPCS A4774

Ammonia test strips, for dialysis, per 50

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $33.11 / $38.02
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94