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South Carolina rates for HCPCS A4911

Drain Bag/Bottle For Dialysis Each (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.03 / $21.03 / $21.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.00 / $17.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00