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Ohio rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.27 / $33.08 / $48.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $12.94 / $13.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.39 / $19.98 / $26.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.74 / $13.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $15.98 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.98 / $85.00 / $85.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $15.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.98 / $2.88