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North Carolina rates for HCPCS A4890

Contracts, Repair and Maintenance, for Home Dialysis Equipment (Non-Co

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.94 / $254.94 / $254.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.60 / $254.94 / $254.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.35 / $496.35 / $545.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.30 / $11.30 / $11.30
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.94 / $254.94 / $374.76
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.17 / $12.17 / $15.64