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Massachusetts rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $15.14
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.89 / $72.44
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.40 / $4.68
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $3.89 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.45 / $4.68