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Indiana rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $12.78 / $13.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $11.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.94 / $16.94 / $25.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.98 / $3.63