go back

North Carolina rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.99 / $13.58 / $13.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.99 / $13.26 / $13.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.83 / $13.99 / $19.38
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.34 / $4.53 / $15.98
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $5.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $2.02 / $2.95
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.72 / $60.72 / $71.91