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Arizona 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
$433.77 / $993.59 / $1,060.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.94 / $89.99 / $310.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.67 / $62.48 / $72.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.77 / $498.84 / $1,060.57