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Maryland 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 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.95 / $3.98 / $5.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.63 / $2.63 / $2.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.45 / $4.47