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Massachusetts rates for HCPCS A4802

Protamine Sulfate For Hemodialysis Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.58 / $13.58
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $4.20 / $60.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $2.58 / $60.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.81 / $2.58 / $4.99