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Virginia rates for HCPCS A4774

Ammonia test strips, for dialysis, per 50

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.20 / $3.20 / $4.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $4.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $6.50 / $6.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.00 / $23.00 / $25.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.20 / $3.36 / $5.41
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