go back

Illinois rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $25.70 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $17.38 / $17.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $5.50 / $6.46
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
$1.45 / $2.19 / $3.89