go back

Oregon rates for HCPCS A4928

Surgical mask, for dialysis, per 20

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $17.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $178.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $2.29
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $2.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $2,250,000.00 / $2,400,000.00