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Michigan rates for HCPCS A4913

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $120.68 / $247.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.75 / $47.25 / $56.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $100.00