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Arizona rates for HCPCS A4802

Protamine Sulfate For Hemodialysis Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.10 / $17.10 / $47.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.26 / $13.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.50 / $18.12 / $21.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.19 / $12.78 / $14.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.99 / $13.58 / $13.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.41 / $13.26 / $17.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $2.17 / $55.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $2.17 / $3.81