go back

Idaho rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.94 / $2.94 / $2.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.26 / $13.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.35 / $13.74 / $17.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,500.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $3.64 / $3.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $2.15 / $2.17