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Montana 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
$4.80 / $8.00 / $531.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $68,099.99 / $68,099.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.00 / $8.00 / $12.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,250,000.00 / $2,400,000.00