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Wisconsin rates for HCPCS A4860

Disposable Catheter Tips For Peritoneal Dialysis Per 10 (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $1.00 / $1.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.01 / $1.01
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.52 / $15.52 / $15.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.28
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1.01 / $1.01
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $4.51 / $5.31