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
$13.49 / $13.49 / $13.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $13.18 / $17.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $12.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $3.63 / $3.63
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $8.71 / $10.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $2.04 / $2.34