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New York rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.03 / $12.78 / $29.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.25 / $13.26 / $13.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $13.32 / $13.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.29 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.59 / $4.86
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.73
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.60 / $6.73 / $6.73
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.29 / $85.00 / $85.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.58 / $4.84
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.73 / $6.73 / $6.73
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.60 / $6.73 / $6.73