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Alaska rates for HCPCS G0491

Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,071.52 / $1,071.52
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,071.52 / $1,737.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,000.00 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,071.52 / $1,737.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26