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Pennsylvania rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $31.78 / $33.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.26 / $13.58
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $3.77 / $3.77
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
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $4.59 / $4.59
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $31.78 / $35.04
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.58 / $16.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.50 / $4.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $85.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.56 / $2.17 / $4.16