go back

North Dakota 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
$12.78 / $12.78 / $12.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $12.78 / $15.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.99 / $14.06 / $15.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $4.69 / $13.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.84 / $11.03 / $13.58
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $2.17 / $55.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.97 / $3.98