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Arizona rates for HCPCS A4913

Miscellaneous Dialysis Supplies Not Otherwise Specified (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.00 / $238.00 / $238.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.50 / $140.00 / $162.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $12.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.05 / $334.05 / $334.05