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Oregon rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $13.49
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
$6.17 / $7.24 / $9.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $13.49 / $20.42
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $12.88
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $6.61 / $6.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $13.18 / $18.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $15.14 / $70.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $7.41 / $9.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $2.19 / $3.63